IJCS | Volume 32, Nº1, January/ February 2019

46 1. What Are Congenital Heart Defects? National Heart, Lung, and Blood Institute: National Heart, Lung, and Blood Institute; 2011. [Cited in 2017 Jan 10]. Available from: https://www.nhlbi.nih.gov/health/health- topics/topics/chd/. 2. Hoffman JI, Kaplan S, Liberthson RR. Prevalence of congenital heart disease. Am Heart J. 2004;147(3):425-39. 3. Khan AM, Paridon SM, Kim YY. Cardiopulmonary exercise testing in adults with congenital heart disease. Expert Rev Cardiovasc Ther. 2014;12(7):863-72. 4. KempnyA, Dimopoulos K, UebingA, Moceri P, Swan L, GatzoulisMA, et al. Reference values for exercise limitations among adults with congenital heart disease. Relation to activities of daily life--single centre experience and review of published data. Eur Heart J. 2012;33(11):1386-96. 5. Buys R, Cornelissen V, Van De Bruaene A, Stevens A, Coeckelberghs E, Onkelinx S, et al. Measures of exercise capacity in adults with congenital heart disease. Int J Cardiol. 2011;153(1):26-30. 6. Trojnarska O, Gwizdała A, Katarzy ń ski S, Katarzy ń ska A, Szyszka A, Lanocha M, et al. Evaluation of exercise capacity with cardiopulmonary exercise test and B-type natriuretic peptide in adults with congenital heart disease. Cardiol J. 2009;16(2):133-41. 7. Miliaresis C, Beker S, Gewitz M. Cardiopulmonary stress testing in children and adults with congenital heart disease. Cardiol Rev. 2014;22(6):275-8. 8. Inuzuka R, Diller GP, Borgia F, Benson L, Tay EL, Alonso-Gonzalez R, et al. Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term. Circulation. 2012;125(2):250-9. 9. Diller GP, Dimopoulos K, Okonko D, Li W, Babu-Narayan SV, Broberg CS, et al. Exercise intolerance in adult congenital heart disease: comparative severity, correlates, and prognostic implication. Circulation. 2005;112(6):828-35. 10. Diller GP, Giardini A, Dimopoulos K, Gargiulo G, Müller J, Derrick G, et al. Predictors of morbidity and mortality in contemporary Fontan patients: results from a multicenter study including cardiopulmonary exercise testing in 321 patients. Eur Heart J. 2010;31(24):3073-83. 11. Giardini A, Specchia S, Tacy TA, Coutsoumbas G, Gargiulo G, Donti A, et al. Usefulness of cardiopulmonary exercise to predict long-term prognosis inadultswithrepairedTetralogyofFallot.AmJCardiol.2007;99(10):1462-7. 12. Giardini A, Specchia S, Berton E, Sangiorgi D, Coutsoumbas G, Gargiulo G, et al. Strong and independent prognostic value of peak circulatory power in adults with congenital heart disease. Am Heart J. 2007;154(3):441-7. 13. Dimopoulos K, Okonko DO, Diller GP, Broberg CS, Salukhe TV, Babu- Narayan SV, et al. Abnormal ventilatory response to exercise in adults with congenital heart disease relates to cyanosis and predicts survival. Circulation. 2006;113(24):2796-802. 14. Diller GP, Dimopoulos K, Okonko D, Uebing A, Broberg CS, Babu- Narayan S, et al. Heart rate response during exercise predicts survival in adults with congenital heart disease. J AmColl Cardiol. 2006;48(6):1250-6. 15. Broberg CS, Burchill LJ. Myocardial factor revisited: The importance of myocardial fibrosis in adults with congenital heart disease. Int J Cardiol. 2015;189:204-10. 16. Bouchardy J, Therrien J, Pilote L, Ionescu-Ittu R, Martucci G, Bottega N, et al. Atrial arrhythmias in adults with congenital heart disease. Circulation. 2009;120(17):1679-86. 17. Broberg CS, Chugh SS, Conklin C, Sahn DJ, Jerosch-Herold M. Quantification of diffuse myocardial fibrosis and its association with myocardial dysfunction in congenital heart disease. Circ Cardiovasc Imaging. 2010;3(6):727-34. 18. Giardini A, Specchia S, Gargiulo G, Sangiorgi D, Picchio FM. Accuracy of oxygen uptake efficiency slope in adults with congenital heart disease. Int J Cardiol. 2009;133(1):74-9. 19. Sharma R, Bolger AP, Li W, Davlouros PA, Volk HD, Poole-Wilson PA, et al. Elevated circulating levels of inflammatory cytokines and bacterial endotoxin in adults with congenital heart disease. Am J Cardiol. 2003;92(2):188-93. References Nascimento et al. Exercise in adults with congenital heart disease Int J Cardiovasc Sci. 2019;32(1)41-47 Original Article Conclusion Adults with congenital heart disease had similar responses to HF patients during a cardiopulmonary exercise test, indicating an impaired aerobic capacity, ventilatory inefficiency for oxygen uptake and reduced inotropic response to exercise. Author contributions Conception and design of the research: Nascimento PMC, Kopiler DA, Cola MCT, Tibiriçá E. Acquisition of data: Nascimento PMC, Kopiler DA, Souza FCC, Cola MCT, CoelhoMP, Lopes GO, Analysis and interpretation of the data: Nascimento PMC, Kopiler DA, Souza FCC, Tibiriçá E. Statistical analysis: Tibiriçá E. Writing of the manuscript: Nascimento PMC, Souza FCC, Tibiriçá E. Critical revision of themanuscript for intellectual content: Nascimento PMC, Kopiler DA, Souza FCC, Cola MCT, Coelho MP, Lopes GO, Tibiriçá E. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is part of the thesis of master submitted by Pablo Marino, from Instituto Nacional de Cardiologia . Ethics approval and consent to participate This study was approved by the Ethics Committee of the Instituto Nacional de Cardiologia under the protocol number 47563315.2.0000.5272. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study.