PMID- 35050237
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220123
IS  - 2308-3425 (Electronic)
IS  - 2308-3425 (Linking)
VI  - 9
IP  - 1
DP  - 2022 Jan 13
TI  - Cardiopulmonary Exercise Testing in Repaired Tetralogy of Fallot: Multiparametric 
      Overview and Correlation with Cardiac Magnetic Resonance and Physical Activity 
      Level.
LID - 10.3390/jcdd9010026 [doi]
LID - 26
AB  - Patients with repaired Tetralogy of Fallot (rToF) typically report having 
      preserved subjective exercise tolerance. Chronic pulmonary regurgitation (PR) 
      with varying degrees of right ventricular (RV) dilation as assessed by cardiac 
      magnetic resonance imaging (MRI) is prevalent in rToF and may contribute to 
      clinical compromise. Cardiopulmonary exercise testing (CPET) provides an 
      objective assessment of functional capacity, and the International Physical 
      Activity Questionnaire (IPAQ) can provide additional data on physical activity 
      (PA) achieved. Our aim was to assess the association between CPET values, IPAQ 
      measures, and MRI parameters. All rToF patients who had both an MRI and CPET 
      performed within one year between March 2019 and June 2021 were selected. 
      Clinical data were extracted from electronic records (including demographic, 
      surgical history, New York Heart Association (NYHA) functional class, QRS 
      duration, arrhythmia, MRI parameters, and CPET data). PA level, based on the 
      IPAQ, was assessed at the time of CPET. Eighty-four patients (22.8 +/- 8.4 years) 
      showed a reduction in exercise capacity (median peak VO(2) 30 mL/kg/min (range 
      25-33); median percent predicted peak VO(2) 68% (range 61-78)). Peak VO(2), 
      correlated with biventricular stroke volumes (RVSV: beta = 6.11 (95%CI, 2.38 to 
      9.85), p = 0.002; LVSV: beta = 15.69 (95% CI 10.16 to 21.21), p < 0.0001) and LVEDVi 
      (beta = 8.74 (95%CI, 0.66 to 16.83), p = 0.04) on multivariate analysis adjusted for 
      age, gender, and PA level. Other parameters which correlated with stroke volumes 
      included oxygen uptake efficiency slope (OUES) (RVSV: beta = 6.88 (95%CI, 1.93 to 
      11.84), p = 0.008; LVSV: beta = 17.86 (95% CI 10.31 to 25.42), p < 0.0001) and peak 
      O(2) pulse (RVSV: beta = 0.03 (95%CI, 0.01 to 0.05), p = 0.007; LVSV: beta = 0.08 (95% 
      CI 0.05 to 0.11), p < 0.0001). On multivariate analysis adjusted for age and 
      gender, PA level correlated significantly with peak VO(2)/kg (beta = 0.02, 95% CI 
      0.003 to 0.04; p = 0.019). We observed a reduction in objective exercise 
      tolerance in rToF patients. Biventricular stroke volumes and LVEDVi were 
      associated with peak VO(2) irrespective of RV size. OUES and peak O(2) pulse were 
      also associated with biventricular stroke volumes. While PA level was associated 
      with peak VO(2), the incremental value of this parameter should be the focus of 
      future studies.
FAU - Leonardi, Benedetta
AU  - Leonardi B
AD  - Department of Cardiology and Cardiac Surgery, Bambino Gesu Children's Hospital 
      IRCCS, 00165 Rome, Italy.
FAU - Gentili, Federica
AU  - Gentili F
AD  - Department of Sport Medicine, Bambino Gesu Children's Hospital IRCCS, 00165 Rome, 
      Italy.
FAU - Perrone, Marco Alfonso
AU  - Perrone MA
AD  - Department of Cardiology and Cardiac Surgery, Bambino Gesu Children's Hospital 
      IRCCS, 00165 Rome, Italy.
AD  - Department of Cardiology and University Sports Centre, University of Rome Tor 
      Vergata, 00133 Rome, Italy.
FAU - Sollazzo, Fabrizio
AU  - Sollazzo F
AD  - Unita Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, 
      Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica 
      del Sacro Cuore, 00168 Rome, Italy.
FAU - Cocomello, Lucia
AU  - Cocomello L
AUID- ORCID: 0000-0002-9967-1861
AD  - Bristol Heart Institute, University of Bristol, Bristol BS2 8HW, UK.
FAU - Silva Kikina, Stefani
AU  - Silva Kikina S
AUID- ORCID: 0000-0003-3228-3773
AD  - Unita Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, 
      Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica 
      del Sacro Cuore, 00168 Rome, Italy.
FAU - Wald, Rachel M
AU  - Wald RM
AD  - Peter Munk Cardiac Centre and Joint Department of Medical Imaging, University 
      Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada.
FAU - Palmieri, Vincenzo
AU  - Palmieri V
AD  - Unita Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, 
      Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica 
      del Sacro Cuore, 00168 Rome, Italy.
FAU - Secinaro, Aurelio
AU  - Secinaro A
AD  - Advanced Cardiothoracic Imaging Unit, Department of Imaging, Bambino Gesu 
      Children's Hospital IRCCS, 00165 Rome, Italy.
FAU - Gagliardi, Maria Giulia
AU  - Gagliardi MG
AD  - Department of Cardiology and Cardiac Surgery, Bambino Gesu Children's Hospital 
      IRCCS, 00165 Rome, Italy.
FAU - Parisi, Attilio
AU  - Parisi A
AD  - Department of Movement, Human and Health Science, University of Rome Foro 
      Italico, 00135 Rome, Italy.
FAU - Turchetta, Attilio
AU  - Turchetta A
AD  - Department of Cardiology and Cardiac Surgery, Bambino Gesu Children's Hospital 
      IRCCS, 00165 Rome, Italy.
FAU - Galletti, Lorenzo
AU  - Galletti L
AD  - Department of Cardiology and Cardiac Surgery, Bambino Gesu Children's Hospital 
      IRCCS, 00165 Rome, Italy.
FAU - Bianco, Massimiliano
AU  - Bianco M
AUID- ORCID: 0000-0002-0587-5899
AD  - Unita Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, 
      Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica 
      del Sacro Cuore, 00168 Rome, Italy.
FAU - Drago, Fabrizio
AU  - Drago F
AUID- ORCID: 0000-0003-1888-373X
AD  - Department of Cardiology and Cardiac Surgery, Bambino Gesu Children's Hospital 
      IRCCS, 00165 Rome, Italy.
LA  - eng
PT  - Journal Article
DEP - 20220113
PL  - Switzerland
TA  - J Cardiovasc Dev Dis
JT  - Journal of cardiovascular development and disease
JID - 101651414
PMC - PMC8778451
OTO - NOTNLM
OT  - cardiac magnetic resonance
OT  - cardiopulmonary exercise testing
OT  - exercise capacity
OT  - physical activity
OT  - pulmonary valve
OT  - tetralogy of Fallot
COIS- The authors certify that there are no conflicts of interest with any financial 
      organization regarding the material discussed in the manuscript.
EDAT- 2022/01/21 06:00
MHDA- 2022/01/21 06:01
PMCR- 2022/01/13
CRDT- 2022/01/20 12:28
PHST- 2021/12/06 00:00 [received]
PHST- 2022/01/07 00:00 [revised]
PHST- 2022/01/10 00:00 [accepted]
PHST- 2022/01/20 12:28 [entrez]
PHST- 2022/01/21 06:00 [pubmed]
PHST- 2022/01/21 06:01 [medline]
PHST- 2022/01/13 00:00 [pmc-release]
AID - jcdd9010026 [pii]
AID - jcdd-09-00026 [pii]
AID - 10.3390/jcdd9010026 [doi]
PST - epublish
SO  - J Cardiovasc Dev Dis. 2022 Jan 13;9(1):26. doi: 10.3390/jcdd9010026.