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
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/7/215 |
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| author | Felix von Sanden Svetlana Ptushkina Julia Hock Celina Fritz Jürgen Hörer Gabriele Hessling Peter Ewert Alfred Hager Cordula M. Wolf |
| author_facet | Felix von Sanden Svetlana Ptushkina Julia Hock Celina Fritz Jürgen Hörer Gabriele Hessling Peter Ewert Alfred Hager Cordula M. Wolf |
| author_sort | Felix von Sanden |
| collection | DOAJ |
| description | 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 (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mover><mi mathvariant="normal">V</mi><mo>.</mo></mover></mrow></semantics></math></inline-formula>O<sub>2</sub>peak) on multivariable analysis. Patients with more advanced age and with <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mover><mi mathvariant="normal">V</mi><mo>.</mo></mover></mrow></semantics></math></inline-formula>O<sub>2</sub>peak 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 <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mover><mi mathvariant="normal">V</mi><mo>.</mo></mover></mrow></semantics></math></inline-formula>O<sub>2</sub>peak predict the risk for severe arrhythmic events and should be considered for risk stratification of SCD in patients with complex CHD. |
| first_indexed | 2024-03-09T13:38:21Z |
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| id | doaj.art-a36f0b8ec60c4e9fb1a8732cba7e7417 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T13:38:21Z |
| publishDate | 2022-07-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-a36f0b8ec60c4e9fb1a8732cba7e74172023-11-30T21:09:17ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-07-019721510.3390/jcdd9070215Peak Oxygen Uptake on Cardiopulmonary Exercise Test Is a Predictor for Severe Arrhythmic Events during Three-Year Follow-Up in Patients with Complex Congenital Heart DiseaseFelix von Sanden0Svetlana Ptushkina1Julia Hock2Celina Fritz3Jürgen Hörer4Gabriele Hessling5Peter Ewert6Alfred Hager7Cordula M. Wolf8Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital and Pediatric Heart Surgery, German Heart Center of Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyDepartment of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, 80636 Munich, GermanyPatients 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 (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mover><mi mathvariant="normal">V</mi><mo>.</mo></mover></mrow></semantics></math></inline-formula>O<sub>2</sub>peak) on multivariable analysis. Patients with more advanced age and with <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mover><mi mathvariant="normal">V</mi><mo>.</mo></mover></mrow></semantics></math></inline-formula>O<sub>2</sub>peak 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 <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mover><mi mathvariant="normal">V</mi><mo>.</mo></mover></mrow></semantics></math></inline-formula>O<sub>2</sub>peak predict the risk for severe arrhythmic events and should be considered for risk stratification of SCD in patients with complex CHD.https://www.mdpi.com/2308-3425/9/7/215congenital heart disease (CHD)sudden cardiac deathventricular arrhythmiaimplantable automatic cardioverter defibrillatorexercise testing in congenital heart diseaseadult congenital heart disease |
| spellingShingle | Felix von Sanden Svetlana Ptushkina Julia Hock Celina Fritz Jürgen Hörer Gabriele Hessling Peter Ewert Alfred Hager Cordula M. Wolf 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 Journal of Cardiovascular Development and Disease congenital heart disease (CHD) sudden cardiac death ventricular arrhythmia implantable automatic cardioverter defibrillator exercise testing in congenital heart disease adult congenital heart disease |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | congenital heart disease (CHD) sudden cardiac death ventricular arrhythmia implantable automatic cardioverter defibrillator exercise testing in congenital heart disease adult congenital heart disease |
| url | https://www.mdpi.com/2308-3425/9/7/215 |
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