Functional Capacity Past Age 40 in Patients With Congenital Ventricular Septal Defects
Open Access
- 6 October 2020
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Heart Association
- Vol. 9 (19)
- https://doi.org/10.1161/jaha.120.015956
Abstract
Background Ventricular septal defects (VSD), when treated correctly in childhood, are considered to have great prognoses, and the majority of patients are discharged from follow‐up when entering their teens. Young adults were previously found to have poorer functional capacity than healthy peers, but the question remains whether functional capacity degenerates further with age. Methods and Results A group of 30 patients with surgically closed VSDs (51±8 years) with 30 matched, healthy control participants (52±9 years) and a group of 30 patients with small unrepaired VSDs (55±12 years) and 30 matched control participants (55±10 years) underwent cardiopulmonary exercise testing using an incremental workload protocol and noninvasive gas measurement. Peak oxygen uptake was lower in participants with closed VSDs than matched controls (24±7 versus 34±9 mL/min per kg, PPPPP=0.14). Exercise capacity was 29% lower in older patients with surgically closed VSDs than healthy peers, whereas younger patients with surgically closed VSDs previously demonstrated 18% lower capacity compared with peers. Older patients with unrepaired VSDs reached 21% lower exercise capacity, whereas younger patients with unrepaired VSDs previously demonstrated 17% lower oxygen uptake than healthy peers. Conclusions Patients with VSDs demonstrate poorer exercise capacity than healthy peers. The difference between patients and control participants increased with advancing age—and increased most in patients with operated VSDs—compared with previous findings in younger patients. Results warrant continuous follow‐up for these simple defects.This publication has 38 references indexed in Scilit:
- ESC Guidelines for the management of grown-up congenital heart disease (new version 2010): The Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology (ESC)European Heart Journal, 2010
- Clinician’s Guide to Cardiopulmonary Exercise Testing in AdultsCirculation, 2010
- Right Ventricular Systolic Pressure Response During Exercise in Adolescents Born With Atrial or Ventricular Septal DefectThe American Journal of Cardiology, 2010
- Current Expectations for Surgical Repair of Isolated Ventricular Septal DefectsThe Annals of Thoracic Surgery, 2010
- Behavior of Unrepaired Perimembranous Ventricular Septal Defect in Young AdultsThe American Journal of Cardiology, 2010
- Cardiorespiratory Fitness as a Quantitative Predictor of All-Cause Mortality and Cardiovascular Events in Healthy Men and WomenJAMA, 2009
- Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics supportJournal of Biomedical Informatics, 2008
- Outcome of patients after surgical closure of ventricular septal defect at young age: longitudinal follow-up of 22?34 yearsEuropean Heart Journal, 2004
- Care of Adults with Congenital Heart Disease - A Challenge for the New Millennium*The Thoracic and Cardiovascular Surgeon, 2001
- Natural history of ventricular septal defect. A study involving 790 cases.Circulation, 1977