초록접수 현황
| 17F-171 | 구연 미채택시 포럼 발표 |
Improvement in Cardiopulmonary Exercise Capacity and its Associated Factors after Pulmonary Valve Replacement in Repaired Tetralogy of Fallot Patients
Yu Rim Shin, Young-Hwan Park, Han Ki Park
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : This study is to evaluate changes in exercise capacity and its predictors in patients who underwent pulmonary valve replacement (PVR) after repair of tetralogy of Fallot (TOF).
Methods : Among patients who underwent PVR after repair of TOF from 2005 to 2016,95 patients underwent cardiopulmonary exercise test and magnetic resonance imaging preoperatively and 1 year postoperatively. The medical records were reviewed.
Results : Patients undergoing PVR demonstrated improvement in exercise performance in terms of percentage of predicted peak oxygen consumption (VO2, 62% vs. 65%, p = 0.02), ratio of minute ventilation to carbon dioxide production (VE/VCO2, 30.1 vs. 27.9, p < 0.01), and heart rate reserve (92 vs. 98 per minute, p = 0.01). However, peak oxygen consumption did not improve in patients with right ventricular end-diastolic volume of more than 160 ml/m2. In multivariable analysis, improvement in peak VO2 was preferable in patients with smaller prosthesis (coefficient = -1.76, p = 0.04). Reduction in the VE/VCO2 slope was poor in patient with significant tricuspid regurgitation (coefficient = -3.62, p = 0.02). Larger right ventricular and left-ventricular volume showed tendency to related with poor exercise performance, however, was not a significant predictor.
Conclusion : PVR allows significant improvement in exercise capacity. However, patients with larger right ventricle did not show improvement. Patients with small prostheses benefit the most in terms of oxygen consumption. In contrast, patients with tricuspid regurgitation showed less favorable changes. Therefore, timely operation before severe dilation of right ventricle or occurrence of significant tricuspid regurgitation may be crucial in terms of exercise. performance.
Methods : Among patients who underwent PVR after repair of TOF from 2005 to 2016,95 patients underwent cardiopulmonary exercise test and magnetic resonance imaging preoperatively and 1 year postoperatively. The medical records were reviewed.
Results : Patients undergoing PVR demonstrated improvement in exercise performance in terms of percentage of predicted peak oxygen consumption (VO2, 62% vs. 65%, p = 0.02), ratio of minute ventilation to carbon dioxide production (VE/VCO2, 30.1 vs. 27.9, p < 0.01), and heart rate reserve (92 vs. 98 per minute, p = 0.01). However, peak oxygen consumption did not improve in patients with right ventricular end-diastolic volume of more than 160 ml/m2. In multivariable analysis, improvement in peak VO2 was preferable in patients with smaller prosthesis (coefficient = -1.76, p = 0.04). Reduction in the VE/VCO2 slope was poor in patient with significant tricuspid regurgitation (coefficient = -3.62, p = 0.02). Larger right ventricular and left-ventricular volume showed tendency to related with poor exercise performance, however, was not a significant predictor.
Conclusion : PVR allows significant improvement in exercise capacity. However, patients with larger right ventricle did not show improvement. Patients with small prostheses benefit the most in terms of oxygen consumption. In contrast, patients with tricuspid regurgitation showed less favorable changes. Therefore, timely operation before severe dilation of right ventricle or occurrence of significant tricuspid regurgitation may be crucial in terms of exercise. performance.
첨부파일 : abstract_신유림.pptx
책임저자: Han Ki Park
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Yu Rim Shin, E-mail : yull0629@yuhs.ac