Assessing utility of exercise test in determining exercise prescription in adolescent and adult patients with repaired tetralogy of fallot

Ming Chun Yang, Chun An Chen, Hsin Hui Chiu, Jou Kou Wang, Ming Tai Lin, Shuenn Nan Chiu, Chun Wei Lu, Shu Chien Huang, Mei Hwan Wu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Parameters from cardiopulmonary exercise test (CPET) are useful prognostic factors for patients with repaired tetralogy of fallot (TOF). Its application in exercise prescription remains unclear. This study sought to define its role. We made current exercise recommendations in repaired TOF patients according to European Society of Cardiology (ESC) guideline, which were based on ventricular function, pressure/volume load, pulmonary artery pressure, hypoxemia and arrhythmic burden both at rest and during exercise. CPET parameters (peak oxygen consumption, oxygen uptake efficiency plateau, and E/CO2 slope), along with cardiothoracic ratio, ventricular arrhythmia, QRS duration and NYHA functional status, were used to calculate “score to exercise”. 112 repaired TOF adolescent and adult aged 32.6 ± 10.8 (14.05- to 56.99-year-old, median 30.1) years received exercise recommendations by ESC guideline, which suggested high, moderate and low intensity sports for 45 (40.2 %), 45 (40.2 %), and 22 (19.6 %) patients, respectively. The optimal cut-off values were 67 and 77 % for peak VO2, 86 and 100 % for OUEP, 22 and 28 for E/CO2 slope to correlate to the exercise intensity recommendation. But, individual CPET parameter had low consistency (41–46 %) in making decisions of exercise intensity compared to ESC recommendations. Using the “score to exercise”, the consistency rate could be increased to 74.1 %. With “score to exercise” recommended exercise intensity, follow-up result revealed no adverse event related to sports. Individual CPET parameter did not correlate well to the exercise recommendation from ESC. We proposed a scoring system, “score to exercise”, which incorporates three CPET parameters with cardiothoracic ratio, ventricular arrhythmia, QRS duration and NYHA functional status. Score to exercise is easy to be assessed and provides useful information for exercise recommendation in patients with repaired TOF.

Original languageEnglish
Pages (from-to)201-207
Number of pages7
JournalHeart and Vessels
Volume32
Issue number2
DOIs
Publication statusPublished - Feb 1 2017

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Keywords

  • Cardiopulmonary exercise test
  • E/CO slope
  • Exercise prescription
  • Oxygen uptake efficiency plateau
  • Peak oxygen consumption
  • Tetralogy of fallot

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Yang, M. C., Chen, C. A., Chiu, H. H., Wang, J. K., Lin, M. T., Chiu, S. N., Lu, C. W., Huang, S. C., & Wu, M. H. (2017). Assessing utility of exercise test in determining exercise prescription in adolescent and adult patients with repaired tetralogy of fallot. Heart and Vessels, 32(2), 201-207. https://doi.org/10.1007/s00380-016-0849-3