Open AccessRelationship between Exercise Parameters and Noninvasive Indices of Right Ventricular Function in Patients with Biventricular Circulation and Systemic Right Ventricle
Author(s) -
Shafer Keri M.,
Mann Nina,
Hehn Rebecca,
Ubeda Tikkanen Ana,
Valente Anne Marie,
Geva Tal,
Gauthier Naomi,
Rhodes Jonathan
Publication year - 2015
Publication title -
congenital heart disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.828
H-Index - 42
eISSN - 1747-0803
pISSN - 1747-079X
DOI - 10.1111/chd.12248
Subject(s) - medicine , cardiology , ventricle , great arteries , ejection fraction , ventricular function , magnetic resonance imaging , systemic circulation , cardiac function curve , vo2 max , heart failure , heart rate , radiology , blood pressure
Objectives In patients with systemic right ventricles ( RVs ) in a biventricular circulation, exercise capacity and RV function often deteriorate over time and echocardiographic assessment of systemic RV function is difficult. The purpose of this study was to examine the relationship between exercise capacity and RV function and to determine which noninvasive imaging parameters correlate most closely with exercise capacity. Design Patients with a systemic RV ( D ‐loop transposition of the great arteries [ TGA ] after atrial switch procedure or physiologically “corrected” TGA ) who underwent cardiopulmonary exercise testing ( CPX ) and noninvasive imaging (cardiac magnetic resonance [ CMR ] and echocardiography [echo]) within 1 year of CPX were identified. Regression analysis was used to evaluate the relationship between exercise variables and noninvasive indices of ventricular function. Results We identified 92 patients with 149 encounters (mean age 31.0 years, 61% men, 70% D ‐loop TGA ) meeting inclusion criteria. Statistically significant correlations between % predicted peak oxygen uptake (%pVO 2 ) and RV ejection fraction ( EF ) ( r = 0.29, P = .0007), indexed RV end‐systolic volume ( r = −0.25, P = .002), and T ei index ( r = −0.22, P = .03) were found. In patients without additional hemodynamically significant lesions, the correlations between %pVO 2 and RV EF ( r = 0.37, P = .0007) and the T ei index ( r = −0.28, P = .03) strengthened and a correlation emerged between % pVO 2 and dP /dt ic ( r = 0.31, P = .007). On multivariable analysis, T ei index was the only statistically significant correlate of %pVO 2 ( P = .04). Conclusions In patients with systemic RVs in a biventricular circulation, CMR ‐derived RVEF and echo‐derived T ei index correlate with % pVO 2 . On multivariable analysis, the T ei index was the strongest predictor of peak % pVO 2 response.