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Erschienen in: Pediatric Cardiology 8/2017

03.08.2017 | Original Article

Importance of Non-invasive Right and Left Ventricular Variables on Exercise Capacity in Patients with Tetralogy of Fallot Hemodynamics

verfasst von: Christian Meierhofer, Timon Tavakkoli, Andreas Kühn, Kurt Ulm, Alfred Hager, Jan Müller, Stefan Martinoff, Peter Ewert, Heiko Stern

Erschienen in: Pediatric Cardiology | Ausgabe 8/2017

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Abstract

Good quality of life correlates with a good exercise capacity in daily life in patients with tetralogy of Fallot (ToF). Patients after correction of ToF usually develop residual defects such as pulmonary regurgitation or stenosis of variable severity. However, the importance of different hemodynamic parameters and their impact on exercise capacity is unclear. We investigated several hemodynamic parameters measured by cardiovascular magnetic resonance (CMR) and echocardiography and evaluated which parameter has the most pronounced effect on maximal exercise capacity determined by cardiopulmonary exercise testing (CPET). 132 patients with ToF-like hemodynamics were tested during routine follow-up with CMR, echocardiography and CPET. Right and left ventricular volume data, ventricular ejection fraction and pulmonary regurgitation were evaluated by CMR. Echocardiographic pressure gradients in the right ventricular outflow tract and through the tricuspid valve were measured. All data were classified and correlated with the results of CPET evaluations of these patients. The analysis was performed using the Random Forest model. In this way, we calculated the importance of the different hemodynamic variables related to the maximal oxygen uptake in CPET (VO2%predicted). Right ventricular pressure showed the most important influence on maximal oxygen uptake, whereas pulmonary regurgitation and right ventricular enddiastolic volume were not important hemodynamic variables to predict maximal oxygen uptake in CPET. Maximal exercise capacity was only very weakly influenced by right ventricular enddiastolic volume and not at all by pulmonary regurgitation in patients with ToF. The variable with the most pronounced influence was the right ventricular pressure.
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Metadaten
Titel
Importance of Non-invasive Right and Left Ventricular Variables on Exercise Capacity in Patients with Tetralogy of Fallot Hemodynamics
verfasst von
Christian Meierhofer
Timon Tavakkoli
Andreas Kühn
Kurt Ulm
Alfred Hager
Jan Müller
Stefan Martinoff
Peter Ewert
Heiko Stern
Publikationsdatum
03.08.2017
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 8/2017
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-017-1697-3

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