Cardiopulmonary Exercise Testing in Adults with Congenital Heart Disease

The primary task of the cardiopulmonary system is to provide blood flow and oxygen in quantities sufficient to support the individual's metabolic needs. The cardiopulmonary system is maximally stressed when an individual's metabolic rate is increased, a condition that occurs most commonly during physical activity or exercise. Cardiopulmonary exercise testing (CPX) quantitatively assesses a patient's capacity to adapt to the hemodynamic demands of exercise. Those who are found to have a cardiopulmonary system incapable of supporting normal amounts of exercise are likely to be less resilient, more vulnerable to illnesses, and more predisposed to health complications when confronting the inevitable challenges of life. A weakened cardiopulmonary system is also likely to be more susceptible to further damage or injury. It is therefore not surprising that data from CPX has been found to carry powerful and important prognostic implications.Article see p 250Indeed, past studies have found that the peak oxygen consumption (Vo2) is one of the best predictors of morbidity or mortality in a variety of cardiovascular conditions including congestive heart failure,1,2 pulmonary hypertension,3 tetralogy of Fallot,4 transposition of the great arteries,5 and Fontan circulations.6 The article by Inuzuka et al7 is the latest contribution to this literature. These investigators have collected a large and diverse cohort of patients with congenital heart disease and have used novel, sophisticated statistical analyses to …