Abnormal ventilatory response to exercise in young adults operated for ventricular septal defect in early childhood: A long-term follow-up

作者：Heiberg Johan^*; Petersen Annemette K; Laustsen Sussie; Hjortdal Vibeke E

来源：International Journal of Cardiology, 2015, 194: 2-6.

DOI：10.1016/j.ijcard.2015.05.071

• Congenital heart disease
• Ventricular septal defect
• Cardiopulmonary exercise testing
• Ventilatory function
• Long-term follow-up

Background: Ventricular septal defects (VSDs) are normally closed in early childhood, and postsurgical physical capacity is generally considered normal. Despite an increasing understanding of late cardiac morbidity among these patients, long-term pulmonary function remains to be investigated. Therefore, the aim of this prospective follow-up study was to describe ventilatory function during exercise in VSD-repaired adults operated in early life.
Methods: We tested cardiopulmonary exercise capacity in 27 patients and 30 healthy control subjects on an ergometer cycle. Each test was preceded by a standard spirometry, and the exercise test was performed as amaximal incremental test. Pulmonary ventilation and gas exchange were simultaneously measured breath-by-breath with minute ventilation at peak exercise as our main endpoint.
Results: In the VSD-group the median surgical age was 1.9 (95% CI 1.1-2.8 years) and the mean age at time of examination was 21.1 +/- 3.1 years in the VSD-group vs. 21.2 +/- 2.5 years in the control group. Meanminute ventilation at peak exercise was significantly lower in the VSD-group compared with the controls: 1.4 +/- 0.4 L/kg/min vs. 1.8 +/- 0.4 L/kg/min, p < 0.01. Likewise, mean oxygen uptake was reduced: 38.0 +/- 8.2 ml/kg/min in the VSD-cohort vs. 47.9 +/- 6.5ml/kg/min among controls, p < 0.01. In terms of breath rate and ventilatory equivalents (O-2 and CO2) there were no differences between the groups.
Conclusions: Patients with a surgically closed VSD have a markedly abnormal ventilatory response to exercise with significantly reduced minute ventilation despite a similar breath rate. With a follow-up of almost two decades our finding most certainly reflects an unknown but persisting abnormality.

• 出版日期2015-9-1