IJCS | Volume 32, Nº1, January/ February 2019
43 Table 1 - Clinical characteristics of the patients Characteristics n % Female/male sex 17/14 54.8/45.2 Age, mean ± SD 35.7 ± 14.2 - Acyanotic /cyanotic 27/4 87.1/12.9 Primary diagnosis Tetralogy of Fallot 9 29.1 Single ventricle 4 12.9 Interventricular communication 3 9.7 Ebstein 2 6.4 Interatrial communication 2 6.4 TGA 2 6.4 Non-compacted myocardium 1 3.2 Tricuspid insufficiency 1 3.2 Tricuspid stenosis 1 3.2 Pulmonary stenosis 1 3.2 Aorta coarctation 1 3.2 Truncus arteriosus 1 3.2 TGA cc 1 3.2 cAVSD 1 3.2 ALCAPA syndrome 1 3.2 TGA: transposition of the great arteries; TGAcc: transposition of the great arteries congenitally corrected; cAVSD: complete atrioventricular septal defect, ALCAPA: Anomalous origin of the left coronary artery from the pulmonary artery. Table 2 - Medications used by the study population Drugs n % Beta-blockers 19 61.3 Diuretics 15 48.4 ACEI 12 38.7 ARB 8 25.8 Warfarin 7 22.6 Sildenafil 5 16.1 Folic acid 4 12.9 Ferrous sulfate 4 12.9 Acetylsalicylic acid 3 9.7 Levothyroxine 3 9.7 Digoxin 2 6.5 Amiodarone 2 6.5 Amlodipine 2 6.5 Statin 2 6.5 Allopurinol 2 6.5 Prednisone 1 3.2 Trimetazidine 1 3.2 Metformin 1 3.2 ACEI: angiotensin converting enzyme inhibitors; ARB: angiotensin II receptor blockers. Nascimento et al. Exercise in adults with congenital heart disease Int J Cardiovasc Sci. 2019;32(1)41-47 Original Article CPET results are described in Table 3. Patients with congenital heart disease evaluated in the present study had reduced aerobic capacity, with a VO 2 max of 44.9% of predicted. AT couldnot be identified in 31 (25.8%) patients. In addition, our study population showed ventilatory inefficiency for oxygen consumption, with OUES of 1.49 (61.4% of predicted) and limited SAP increment in response to exercise (∆SAP: 31.4 mmHg). Also, patients showed reduced O 2 P (8.7 mL/beat; 58.9% of the predicted value), even when only acyanotic subgroup was considered in the analysis (9.1 mL/beat; 60.9% of the predicted value). Duration of the ramp exercise test was 9.2 ± 3.6 minutes, which was considered adequate. R value was 1.21 ± 0.26, indicating maximum efficiency of the test. According to the Brazilian Society of Cardiology criteria, 22 the prevalence of parasympathetic autonomic dysfunction was 22.2%, and the small increase in SAP during incremental exercise indicated depressed response of this parameter. The prevalence of chronotropic incompetence was 44.4% based on different cut-off points for beta-blocker users 26 and non-users 22 (0.62 and 0.80, respectively). Given the impossibility of HR measurement, patients with a permanent pacemaker (n = 3) and patients with atrial fibrillation (n = 1) were excluded fromO 2 P analysis, chronotropic response (HRR and chronotropic index) and parasympathetic autonomous modulation (HRrec). Discussion In the present study, we showed that adult patients with congenital heart disease have reduced aerobic
Made with FlippingBook
RkJQdWJsaXNoZXIy MjM4Mjg=