RT Journal Article
SR Electronic
T1 Functional outcome in contemporary children and young adults with tetralogy of Fallot after repair
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 129
OP 133
DO 10.1136/archdischild-2017-314733
VO 104
IS 2
A1 Julia Hock
A1 Anna-Luisa Häcker
A1 Barbara Reiner
A1 Renate Oberhoffer
A1 Alfred Hager
A1 Peter Ewert
A1 Jan Müller
YR 2019
UL http://adc.bmj.com/content/104/2/129.abstract
AB Objective Functional outcome measures are of growing importance in the aftercare of patients with congenital heart disease. This study addresses the functional status with regard to exercise capacity, health-related physical fitness (HRPF) and arterial stiffness in a recent cohort of children, adolescents and young adults with tetralogy of Fallot (ToF) after repair.Design Single-centre, uncontrolled and prospective cohort study.Setting Outpatient department of the German Heart Centre Munich; July 2014–January 2018.Patients One hundred and six patients with ToF after repair (13.5±3.7 years, 40 females) were included. Data were compared with a recent cohort of healthy controls (HCs) (n=1700, 12.8±2.6 years, 833 females).Main outcome measures Patients underwent a symptom-limited cardiopulmonary exercise test, performed an HRPF test (FitnessGram) and had an assessment of their arterial stiffness (Mobil-O-Graph).Results Compared with HC, patients with ToF showed lower predicted O2 peak (ToF: 80.4% ± 16.8% vs HC: 102.6% ± 18.1%, p<0.001), impaired ventilatory efficiency (ToF: 29.6 ± 3.6 vs HC: 27.4 ± 2.9, p<0.001), chronotropic incompetence (ToF: 167 ± 17 bpm vs HC: 190 ± 17 bpm, p<0.001) and reduced HRPF (ToF z-score: −0.65 ± 0.87 vs HC z-score: 0.03 ± 0.65, p<0.001). Surrogates of arterial stiffness, central and peripheral systolic blood pressure, did not differ between the two groups.Conclusions Contemporary children, adolescents and young adults with ToF still have functional limitations. How impaired HRPF and limited exercise capacity interact and how they can be modified needs to be evaluated in further intervention studies.