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Peak Oxygen Uptake on Cardiopulmonary Exercise Test Is a Predictor for Severe Arrhythmic Events during Three-Year Follow-Up in Patients with Complex Congenital Heart Disease.

ABSTRACT: Patients with congenital heart disease (CHD) are at increased risk for severe arrhythmia and sudden cardiac death (SCD). Although implantable cardioverter defibrillators (ICD) effectively prevent SCD, risk stratification for primary prophylaxis in patients with CHD remains challenging. Patients with complex CHD undergoing CPET were included in this single-center study. Univariable and backwards stepwise multivariable logistic regression models were used to identify variables associated with the endpoint of severe arrhythmic event during three years of follow-up. Cut-off values were established with receiver operating characteristic (ROC) curve analysis. Survival analysis was conducted via Kaplan-Meier plots. Severe Arrhythmia was documented in 97 of 1194 patients (8.1%/3 years). Independent risk factors for severe arrhythmia during follow-up were old age and a low peak oxygen uptake (V.O₂peak) on multivariable analysis. Patients with more advanced age and with V.O₂peak values of less than 24.9 mL/min/kg were at significantly increased risk for the occurrence of severe arrhythmias during follow-up. The combined analysis of both risk factors yielded an additional benefit for risk assessment. Age at CPET and V.O₂peak predict the risk for severe arrhythmic events and should be considered for risk stratification of SCD in patients with complex CHD.

SUBMITTER: von Sanden F

PROVIDER: S-EPMC9320423 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Peak Oxygen Uptake on Cardiopulmonary Exercise Test Is a Predictor for Severe Arrhythmic Events during Three-Year Follow-Up in Patients with Complex Congenital Heart Disease.

von Sanden Felix F Ptushkina Svetlana S Hock Julia J Fritz Celina C Hörer Jürgen J Hessling Gabriele G Ewert Peter P Hager Alfred A Wolf Cordula M CM

Journal of cardiovascular development and disease 20220704 7

Patients with congenital heart disease (CHD) are at increased risk for severe arrhythmia and sudden cardiac death (SCD). Although implantable cardioverter defibrillators (ICD) effectively prevent SCD, risk stratification for primary prophylaxis in patients with CHD remains challenging. Patients with complex CHD undergoing CPET were included in this single-center study. Univariable and backwards stepwise multivariable logistic regression models were used to identify variables associated with the ...[more]

PMID: 35877577

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Project description:Objective: To compare peak oxygen uptake (VO2peak) and the test-retest reliability of physiological parameters between a 1-min and a 3-min closed-end and an incremental open-end upper-body poling test. Methods: On two separate test days, 24 healthy, upper-body trained men (age: 28.3 ± 9.3 years, body mass: 77.4 ± 8.9 kg, height: 182 ± 7 cm) performed a 1-min, a 3-min and an incremental test to volitional exhaustion in the same random order. Respiratory parameters, heart rate (HR), blood lactate concentration (BLa), rating of perceived exertion (RPE), and power output were measured. VO2peak was determined as the single highest 30-s average. Relative reliability was assessed with the intra-class correlation coefficient (ICC2, 1) and absolute reliability with the standard error of measurement (SEM) and smallest detectable change (SDC). Results: The incremental (3.50 ± 0.46 L·min-1 and 45.4 ± 5.5 mL·kg-1·min-1) and the 3-min test (3.42 ± 0.47 L·min-1 and 44.5 ± 5.5 mL·kg-1·min-1) resulted in significantly higher absolute and body-mass normalized VO2peak compared to the 1-min test (3.13 ± 0.40 L·min-1 and 40.4 ± 5.0 mL·kg-1·min-1) (all comparisons, p < 0.001). Furthermore, the incremental test resulted in a significantly higher VO2peak as compared to the 3-min test (p < 0.001). VO2peak was significantly higher on day 1 than day 2 for the 1-min test (p < 0.05) and displayed a trend toward higher values on day 2 for the incremental test (p = 0.07). High and very high ICCs across all physiological parameters were found for the 1-min (0.827-0.956), the 3-min (0.916-0.949), and the incremental test (0.728-0.956). The SDC was consistently small for HR (1-min: 4%, 3-min: 4%, incremental: 3%), moderate for absolute and body-mass normalized VO2peak (1-min: 5%, 3-min: 6%, incremental: 7%) and large for BLa (1-min: 20%, 3-min: 12%, incremental: 22%). Conclusions: Whereas both the 3-min and the incremental test display high relative reliability, the incremental test induces slightly higher VO2peak. However, the 3-min test seems to be more stable with respect to day-to-day differences in VO2peak. The 1-min test would provide a reliable alternative when short test-duration is desirable, but is not recommended for testing VO2peak due to the clearly lower values.

Dataset Information

Peak Oxygen Uptake on Cardiopulmonary Exercise Test Is a Predictor for Severe Arrhythmic Events during Three-Year Follow-Up in Patients with Complex Congenital Heart Disease.

Publications

Peak Oxygen Uptake on Cardiopulmonary Exercise Test Is a Predictor for Severe Arrhythmic Events during Three-Year Follow-Up in Patients with Complex Congenital Heart Disease.

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