Exercise testing in adult congenital heart disease: At center stage for many reasons
Adult survivors with congenital heart disease represent rapidly evolving cohorts of complex patients that pose unique challenges to our adult cardiology clinics. These patients are at high risk of cardiovascular complications and premature death as young adults. Regular assessment at specialist cent...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-02-01
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| Series: | International Journal of Cardiology Congenital Heart Disease |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666668521000112 |
| _version_ | 1819063942021906432 |
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| author | Matthias Greutmann |
| author_facet | Matthias Greutmann |
| author_sort | Matthias Greutmann |
| collection | DOAJ |
| description | Adult survivors with congenital heart disease represent rapidly evolving cohorts of complex patients that pose unique challenges to our adult cardiology clinics. These patients are at high risk of cardiovascular complications and premature death as young adults. Regular assessment at specialist centers by multidisciplinary expert teams is key to optimal management. Serial exercise testing has proven to be a powerful tool for optimal management of these patients.In this overview, the major tasks of exercise testing are reviewed. This includes prognostication and risk stratification as well, as the evaluation of specific causes of impaired exercise capacity based on analysis of the different components of cardio-pulmonary exercise testing. While peak oxygen consumption has proven to be a robust marker of outcome in adult cardiology, in patients with congenital heart disease, reference values may need to be adapted to specific congenital heart disease entities and the prognostic validity for specific patient cohorts requires further elucidation. Careful analysis of results from exercise testing often reveal important insights into the individual patient's cardiac physiology and may allow targeted interventions that improve exercise capacity and potentially outcome. This requires integration of clinical findings and findings from cardiac imaging. Occasionally, exercise testing during cardiac catheterization may reveal insights into exercise hemodynamics and may be important for decision-making, particularly for decision-making about occlusion of intra-cardiac shunts.From a research perspective, the analysis of exercise capacity and its components will enable us to make more evidence-based decisions for cardiac interventions and will allow a better understanding of prognosis. |
| first_indexed | 2024-12-21T15:22:41Z |
| format | Article |
| id | doaj.art-09f89190dda444549a29962df276fd2c |
| institution | Directory Open Access Journal |
| issn | 2666-6685 |
| language | English |
| last_indexed | 2024-12-21T15:22:41Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj.art-09f89190dda444549a29962df276fd2c2022-12-21T18:58:59ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852021-02-012100087Exercise testing in adult congenital heart disease: At center stage for many reasonsMatthias Greutmann0University Heart Center, Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandAdult survivors with congenital heart disease represent rapidly evolving cohorts of complex patients that pose unique challenges to our adult cardiology clinics. These patients are at high risk of cardiovascular complications and premature death as young adults. Regular assessment at specialist centers by multidisciplinary expert teams is key to optimal management. Serial exercise testing has proven to be a powerful tool for optimal management of these patients.In this overview, the major tasks of exercise testing are reviewed. This includes prognostication and risk stratification as well, as the evaluation of specific causes of impaired exercise capacity based on analysis of the different components of cardio-pulmonary exercise testing. While peak oxygen consumption has proven to be a robust marker of outcome in adult cardiology, in patients with congenital heart disease, reference values may need to be adapted to specific congenital heart disease entities and the prognostic validity for specific patient cohorts requires further elucidation. Careful analysis of results from exercise testing often reveal important insights into the individual patient's cardiac physiology and may allow targeted interventions that improve exercise capacity and potentially outcome. This requires integration of clinical findings and findings from cardiac imaging. Occasionally, exercise testing during cardiac catheterization may reveal insights into exercise hemodynamics and may be important for decision-making, particularly for decision-making about occlusion of intra-cardiac shunts.From a research perspective, the analysis of exercise capacity and its components will enable us to make more evidence-based decisions for cardiac interventions and will allow a better understanding of prognosis.http://www.sciencedirect.com/science/article/pii/S2666668521000112Adult congenital heart diseaseExercise testingCardio-pulmonary exercise testingPeak oxygen consumptionOxygen pulse |
| spellingShingle | Matthias Greutmann Exercise testing in adult congenital heart disease: At center stage for many reasons International Journal of Cardiology Congenital Heart Disease Adult congenital heart disease Exercise testing Cardio-pulmonary exercise testing Peak oxygen consumption Oxygen pulse |
| title | Exercise testing in adult congenital heart disease: At center stage for many reasons |
| title_full | Exercise testing in adult congenital heart disease: At center stage for many reasons |
| title_fullStr | Exercise testing in adult congenital heart disease: At center stage for many reasons |
| title_full_unstemmed | Exercise testing in adult congenital heart disease: At center stage for many reasons |
| title_short | Exercise testing in adult congenital heart disease: At center stage for many reasons |
| title_sort | exercise testing in adult congenital heart disease at center stage for many reasons |
| topic | Adult congenital heart disease Exercise testing Cardio-pulmonary exercise testing Peak oxygen consumption Oxygen pulse |
| url | http://www.sciencedirect.com/science/article/pii/S2666668521000112 |
| work_keys_str_mv | AT matthiasgreutmann exercisetestinginadultcongenitalheartdiseaseatcenterstageformanyreasons |