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Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention?
Cardiol J. 2015; 22(3):343-50.CJ

Abstract

BACKGROUND

The aim of the study was to evaluate the role of cardiopulmonary exercise testing (CPET) parameters in assessing exercise capacity improvement after percutaneous pulmonary valve implantation (PPVI). Additionally, it aimed to determine if there are any baseline characteristics influencing that change.

METHODS AND RESULTS

The study comprised 32 patients (mean age 26 ± 9); 53% males; diagnosis: tetralogy of Fallot (n = 18), pulmonary atresia (n = 6), Ross procedure (n = 4), other (transposition of great arteries, pulmonary stenosis, double outlet right ventricle, common arterial trunk type II--n = 4) who underwent successful PPVI due to right ventricular out-flow tract dysfunction (predominant pulmonary regurgitation--n = 17, predominant pulmonary stenosis--n = 15). Treadmill CPET was performed before and a year after PPVI along with clinical evaluation, cardiac magnetic resonance and transthoracic echocardiography. Twelve months post successful PPVI (pulmonary valve competence restoration and pulmonary gradient reduction from 58.8 ± 47.1 to 26.6 ± 10.8 mm Hg) there was a significant decrease in the ventilatory equivalent for CO2 at peak exercise (EQCO₂) (25.3 ± 3.3 to 24.3 ± 3.0, p = 0.04) and oxygen consumption at peak exercise (pVO2) (20.4 ± 5.0 to 22.6 ± 5.3 mL/kg/min, p = 0.04). Improved EQCO2 correlated with an increase in right and left ventricular ejection fraction (respectively R = -0.57, p = 0.002; R = -0.56, p = 0.002). In this study, no baseline factors that might affect improvement in exercise function were found.

CONCLUSIONS

Successful PPVI leads to an improvement in exercise capacity and hemodynamic response to exercise. The correlation between the improvement in EQCO2 or peak VO2 and baseline characteristics was too weak to reliably identify the group of patients that will benefit from the procedure.

Authors+Show Affiliations

Department of Congenital Heart Diseases, Institute of Car diology Warsaw. k.biernacka@ikard.pl.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25733320

Citation

Biernacka, Elżbieta Katarzyna, et al. "Influence of Percutaneous Pulmonary Valve Implantation On Exercise Capacity: Which Group of Patients Benefits Most From the Intervention?" Cardiology Journal, vol. 22, no. 3, 2015, pp. 343-50.
Biernacka EK, Piotrowicz E, Fronczak A, et al. Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention? Cardiol J. 2015;22(3):343-50.
Biernacka, E. K., Piotrowicz, E., Fronczak, A., Mazgaj, M., Demkow, M., Rużyłło, W., Śpiewak, M., Kowalski, M., Piotrowicz, R., Weroński, K., & Hoffman, P. (2015). Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention? Cardiology Journal, 22(3), 343-50. https://doi.org/10.5603/CJ.a2015.0013
Biernacka EK, et al. Influence of Percutaneous Pulmonary Valve Implantation On Exercise Capacity: Which Group of Patients Benefits Most From the Intervention. Cardiol J. 2015;22(3):343-50. PubMed PMID: 25733320.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention? AU - Biernacka,Elżbieta Katarzyna, AU - Piotrowicz,Ewa, AU - Fronczak,Aneta, AU - Mazgaj,Magdalena, AU - Demkow,Marcin, AU - Rużyłło,Witold, AU - Śpiewak,Mateusz, AU - Kowalski,Mirosław, AU - Piotrowicz,Ryszard, AU - Weroński,Krzysztof, AU - Hoffman,Piotr, Y1 - 2015/03/03/ PY - 2014/07/11/received PY - 2015/01/27/accepted PY - 2015/02/25/revised PY - 2015/3/4/entrez PY - 2015/3/4/pubmed PY - 2016/9/7/medline SP - 343 EP - 50 JF - Cardiology journal JO - Cardiol J VL - 22 IS - 3 N2 - BACKGROUND: The aim of the study was to evaluate the role of cardiopulmonary exercise testing (CPET) parameters in assessing exercise capacity improvement after percutaneous pulmonary valve implantation (PPVI). Additionally, it aimed to determine if there are any baseline characteristics influencing that change. METHODS AND RESULTS: The study comprised 32 patients (mean age 26 ± 9); 53% males; diagnosis: tetralogy of Fallot (n = 18), pulmonary atresia (n = 6), Ross procedure (n = 4), other (transposition of great arteries, pulmonary stenosis, double outlet right ventricle, common arterial trunk type II--n = 4) who underwent successful PPVI due to right ventricular out-flow tract dysfunction (predominant pulmonary regurgitation--n = 17, predominant pulmonary stenosis--n = 15). Treadmill CPET was performed before and a year after PPVI along with clinical evaluation, cardiac magnetic resonance and transthoracic echocardiography. Twelve months post successful PPVI (pulmonary valve competence restoration and pulmonary gradient reduction from 58.8 ± 47.1 to 26.6 ± 10.8 mm Hg) there was a significant decrease in the ventilatory equivalent for CO2 at peak exercise (EQCO₂) (25.3 ± 3.3 to 24.3 ± 3.0, p = 0.04) and oxygen consumption at peak exercise (pVO2) (20.4 ± 5.0 to 22.6 ± 5.3 mL/kg/min, p = 0.04). Improved EQCO2 correlated with an increase in right and left ventricular ejection fraction (respectively R = -0.57, p = 0.002; R = -0.56, p = 0.002). In this study, no baseline factors that might affect improvement in exercise function were found. CONCLUSIONS: Successful PPVI leads to an improvement in exercise capacity and hemodynamic response to exercise. The correlation between the improvement in EQCO2 or peak VO2 and baseline characteristics was too weak to reliably identify the group of patients that will benefit from the procedure. SN - 1897-5593 UR - https://www.unboundmedicine.com/medline/citation/25733320/Influence_of_percutaneous_pulmonary_valve_implantation_on_exercise_capacity:_Which_group_of_patients_benefits_most_from_the_intervention L2 - http://czasopisma.viamedica.pl/cj/article/view/38909 DB - PRIME DP - Unbound Medicine ER -