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