CARDIOPULMONARY EXERCISE CAPACITY IN PATI ENTS WITH CONGENITAL HEART-DISEASE

Cardiopulmonary exercise capacity is a significant criterion of life q uality. The evaluation of the exercise capacity is important to answer patient-questions concerning every day activity, choice of profession , sports-activity etc. We performed cardiopulmonary exercise testing i n 38 patients (age 33.6 +/- 12.0 years, 18 women, 20 men) with differe nt congenital heart disease (5 after surgical repair of tetralogy of f allot, 2 after Mustard-operation in transposition of the great arterie s (TGA), 1 single ventricle, 14 atrial septal defect (ASD), 8 ventricu lar septal defect (VSD), 8 pulmonary valve stenosis (PS)) during outpa tient routine control. All tests were performed on upright bicycle wit h continuous ramp program of 20 Watt increase/minute. Ventilatory valu es as O-2-uptake, CO2-production, minute ventilation (VE) were measure d breath-by-breath. Max. VO2 was reduced as average value for every pa tient group (tetralogy of fallot 60.2 +/- 20.3 % pred., TGA 53.0 +/- 0 .0% pred., single ventricle 35 % pred., closed ASD 71.9 +/- 23.8 % pre d., ASD 62.7 +/- 30.0 % pred., VSD 64.1 +/- 11.7 % pred., PS 73.2 +/- 16.0% pred.). Anaerobic threshold was reduced in tetralogy of fallot ( 35.9 +/- 12.2 % pred. max. VO2) and in single ventricle (28.3 % pred. max. VO2). In comparison with clinical classification of exercise capa city we found for max. VO2 differences in 23/38 patients. 22/23 patien ts reported no exercise limitation but had reduced max. VO2. One patie nt had a normal max. VO2 but complaints of exercise dyspnoe. For anaer obic threshold 18/38 patients had discrepancies in objective and subje ctive estimation of their exercise capacity. Cardiopulmonary exercise testing demonstrated a wide ranging, but (as mean value) a reduced car diopulmonary exercise capacity in all patient groups. The differences between subjective and objective evaluation gives important additional information about the patients status.