open access

Vol 22, No 3 (2015)
Original articles
Published online: 2015-06-19
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Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention?

Elżbieta Katarzyna Biernacka, Ewa Piotrowicz, Aneta Fronczak, Magdalena Mazgaj, Marcin Demkow, Witold Rużyłło, Mateusz Śpiewak, Mirosław Kowalski, Ryszard Piotrowicz, Krzysztof Weroński, Piotr Hoffman
DOI: 10.5603/CJ.a2015.0013
·
Pubmed: 25733320
·
Cardiol J 2015;22(3):343-350.

open access

Vol 22, No 3 (2015)
Original articles
Published online: 2015-06-19

Abstract

Background: The aim of the study was to evaluate the role of cardiopulmonary exercise testing (CPET) parameters in assessing exercise capacity improvement after percutaneous pulmonary valve implantation (PPVI). Additionally, it aimed to determine if there are any baseline characteristics influencing that change.

Methods and results: The study comprised 32 patients (mean age 26 ± 9); 53% males; diagnosis: tetralogy of Fallot (n = 18), pulmonary atresia (n = 6), Ross procedure (n = 4), other (transposition of great arteries, pulmonary stenosis, double outlet right ventricle, common arterial trunk type II — n = 4) who underwent successful PPVI due to right ventricular out­flow tract dysfunction (predominant pulmonary regurgitation — n = 17, predominant pulmo­nary stenosis — n = 15). Treadmill CPET was performed before and a year after PPVI along with clinical evaluation, cardiac magnetic resonance and transthoracic echocardiography. Twelve months post successful PPVI (pulmonary valve competence restoration and pulmonary gradient reduction from 58.8 ± 47.1 to 26.6 ± 10.8 mm Hg) there was a significant decrease in the ventilatory equivalent for CO2 at peak exercise (EQCO2) (25.3 ± 3.3 to 24.3 ± 3.0, p = 0.04) and oxygen consumption at peak exercise (pVO2) (20.4 ± 5.0 to 22.6 ± 5.3 mL/kg/min, p = 0.04). Improved EQCO2 correlated with an increase in right and left ventricular ejection fraction (respectively R = –0.57, p = 0.002; R = –0.56, p = 0.002). In this study, no baseline factors that might affect improvement in exercise function were found.

Conclusions: Successful PPVI leads to an improvement in exercise capacity and hemodynamic response to exercise. The correlation between the improvement in EQCO2 or peak VO2 and baseline characteristics was too weak to reliably identify the group of patients that will benefit from the procedure

Abstract

Background: The aim of the study was to evaluate the role of cardiopulmonary exercise testing (CPET) parameters in assessing exercise capacity improvement after percutaneous pulmonary valve implantation (PPVI). Additionally, it aimed to determine if there are any baseline characteristics influencing that change.

Methods and results: The study comprised 32 patients (mean age 26 ± 9); 53% males; diagnosis: tetralogy of Fallot (n = 18), pulmonary atresia (n = 6), Ross procedure (n = 4), other (transposition of great arteries, pulmonary stenosis, double outlet right ventricle, common arterial trunk type II — n = 4) who underwent successful PPVI due to right ventricular out­flow tract dysfunction (predominant pulmonary regurgitation — n = 17, predominant pulmo­nary stenosis — n = 15). Treadmill CPET was performed before and a year after PPVI along with clinical evaluation, cardiac magnetic resonance and transthoracic echocardiography. Twelve months post successful PPVI (pulmonary valve competence restoration and pulmonary gradient reduction from 58.8 ± 47.1 to 26.6 ± 10.8 mm Hg) there was a significant decrease in the ventilatory equivalent for CO2 at peak exercise (EQCO2) (25.3 ± 3.3 to 24.3 ± 3.0, p = 0.04) and oxygen consumption at peak exercise (pVO2) (20.4 ± 5.0 to 22.6 ± 5.3 mL/kg/min, p = 0.04). Improved EQCO2 correlated with an increase in right and left ventricular ejection fraction (respectively R = –0.57, p = 0.002; R = –0.56, p = 0.002). In this study, no baseline factors that might affect improvement in exercise function were found.

Conclusions: Successful PPVI leads to an improvement in exercise capacity and hemodynamic response to exercise. The correlation between the improvement in EQCO2 or peak VO2 and baseline characteristics was too weak to reliably identify the group of patients that will benefit from the procedure

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Keywords

percutaneous pulmonary valve implantation, cardiopulmonary exercise testing, grown up congenital heart disease

About this article
Title

Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention?

Journal

Cardiology Journal

Issue

Vol 22, No 3 (2015)

Pages

343-350

Published online

2015-06-19

DOI

10.5603/CJ.a2015.0013

Pubmed

25733320

Bibliographic record

Cardiol J 2015;22(3):343-350.

Keywords

percutaneous pulmonary valve implantation
cardiopulmonary exercise testing
grown up congenital heart disease

Authors

Elżbieta Katarzyna Biernacka
Ewa Piotrowicz
Aneta Fronczak
Magdalena Mazgaj
Marcin Demkow
Witold Rużyłło
Mateusz Śpiewak
Mirosław Kowalski
Ryszard Piotrowicz
Krzysztof Weroński
Piotr Hoffman

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