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Cited by 47Congenital Heart Disease StudiesCardiovascular and exercise physiologyCardiovascular Effects of Exercise

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The Role of Cardiopulmonary Exercise Testing for Decision Making in Patients with Repaired Tetralogy of Fallot

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Dallaire, Frederic, Wald, Rachel M., Marelli, Ariane·2017·Pediatric Cardiology
DOI 10.1007/s00246-017-1656-z
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Abstract

Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. As a result of the surgical strategies employed at the time of initial repair, chronic pulmonary regurgitation (PR) is prevalent in this population. Despite sustained research efforts, patient selection and timing of pulmonary valve replacement (PVR) to address PR in young asymptomatic patients with repaired tetralogy of Fallot (rToF) remain a fundamental but as yet unanswered question in the field of congenital heart disease. The ability of the heart to compensate for the chronic volume overload imposed by PR is critical in the evaluation of the risks and benefits of PVR. The difficulty in clarifying the functional impact of PR on the cardiovascular capacity may be in part responsible for the uncertainty surrounding the timing of PVR. Cardiopulmonary exercise testing (CPET) may be used to assess abnormal cardiovascular response to increased physiologic demands. However, its use as a tool for risk stratification in asymptomatic adolescents and young adults with rToF is still ill-defined. In this paper, we review the role of CPET as a potentially valuable adjunct to current risk stratification strategies with a focus on asymptomatic rToF adolescents and young adults being considered for PVR. The role of maximal and submaximal exercise measurements to identify young patients with a decreased or borderline low peak VO 2 resulting from impaired ventricular function is explored. Current knowledge gaps and research perspectives are highlighted.

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Crossref · 10.1007/s00246-017-1656-z

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  • It is still unclear how best to integrate exercise parameters into management algorithms to support clinical decisions such as pulmonary valve replacement, and a real benefit in exercise capacity and CPET results after PVR has not been demonstrated yet.

    “However, it is still unclear how best to integrate these exercise parameters into management algorithms to support clinical decisions, such as pulmonary valve replacement (PVR) [104]. This would be of great interest, especially in asymptomatic patients, where the identification of early sub-clinical dysfunction with objective parameters may represent a boost for PVR. Nevertheless, it should be”

    From Multimodality imaging assessment of tetralogy of Fallot: From diagnosis to long-term follow-up (2023) · cites this paper as [104]

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Metadata

Authors
Dallaire, F., Wald, R. M., & Marelli, A.
Affiliations
  • University Health Network (CA)
  • McGill University Health Centre (CA)
ORCID
Venue
Pediatric Cardiology
Publisher
Springer Science and Business Media LLC
Published
2017-06-16
Volume
38
Issue
6
Pages
1097-1105
ISSN
  • 0172-0643 (ISSN-L)
  • 1432-1971
DOI
10.1007/s00246-017-1656-z
OpenAlex
W2626200346
Cited by
47
References
3
Citations by year
2026: 3 · 2025: 5 · 2024: 8 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 8
FWCI
0.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Pediatric Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Knowledge UdeS (Institutional Deposit of the University of Sherbrooke) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Keywords
repaired tetralogy of Fallot, cardiopulmonary exercise testing, pulmonary valve replacement, risk stratification, peak oxygen uptake, submaximal exercise, ventricular function, congenital heart disease, patient selection
MeSH terms
Exercise Test, Humans, Pulmonary Valve Insufficiency, Tetralogy of Fallot, Time Factors, Risk Assessment, Patient Selection, Ventricular Dysfunction

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