Cardiopulmonary Exercise Testing and Quality of Life Reevaluation in Adults after Arterial Switch Operation for d-transposition of the Great Arteries—A Longitudinal Comparison at Intervals of 9 Years
The Thoracic and Cardiovascular Surgeon, vol. 73
Abstract
All articles of this category (opens in new window) Background: As part of our follow-up program for d-transposition of the Great Arteries (dTGA) after arterial switch operation (ASO), we reevaluated objective exercise capacity and health-related quality of life (QOL) in adults with increasing age. Methods: Forty-six patients were reevaluated after a 9-year interval with Cardiopulmonary Exercise Testing (CPET; bicycle) and QOL questionnaire (SF-36) at a mean age of 32 years (Date 2). CPET parameters and QOL scores were compared by the Wilcoxon test with their corresponding results from 9 years ago (Date 1). Results: CPET: All patients reached maximal exercise effort. Max. power (mean 2.5 vs. 2.2 W/kg, p < 0.001), decreased over time. Peak oxygen uptake (percentage of predicted peak VO 2 according to Wasserman; mean 82.4 ± 14.0 vs. 81.3 ± 13.7%; p = 0.83) was unchanged. The norm percentile according to Dubowy (mean 9.3 ± 13.4 vs. 10.8 ± 11.3; p = 0.09) was unchanged. Ventilatory efficiency at the anaerobic threshold (slope f[VE/VCO 2 ]; mean 25.7 ± 2.1 vs. 31.3 ± 4.3; p < 0.001), worsened over time. Oxygen pulse (O 2 HR % of predicted; mean 97.1 ± 14.6 vs. 89.0 ± 16.3; p = 0.036) decreased. Breathing equivalent for CO 2 at anaerobic threshold (EQCO 2 ): mean 25.5 ± 2.3 versus 26.7 ± 2.8 ( p = 0.039), increased but stayed normal. QOL: Physical functioning was better than 9 years ago, each compared with the gender- and age-appropriate 50th standard percentiles. There were no significant differences in the scores for mental health and general health perception over time (see [ Table 1 ]). Table 1 SF-36 Scores SF-36 scores: Time of examination Patients (m ± SD) Norm (m ± SD) p -Value Physical functioning Date 1 93.13 ± 16.96 95.81 ± 12.84 0.14 Date 2 97.00 ± 5.71 93.71 ± 1.17 <0.01 Mental health Date 1 76.18 ± 15.29 75.30 ± 17.07 0.58 Date 2 73.83 ± 19.56 73.90 ± 0.93 0.58 General health perception Date 1 77.69 ± 17.97 77.48 ± 18.31 0.91 Date 2 77.77 ± 17.72 74.43 ± 1.00 0.153 Conclusion: In the fourth decade after ASO for TGA, a persistent borderline normal functional status according to CPET criteria is present, with no decline after a 9-year interval. A good physical, psychological, and general quality of life is preserved over time. Publication History Article published online: 11 February 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Authors 6
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Affiliation as printed
Klinik für Kinderkardiologie und angeborene Herzfehler, Uniklinik RWTH Aachen, Aachen, Deutschland
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Affiliation as printed
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Uniklinik RWTH Aachen, Aachen, Deutschland
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Affiliation as printed
Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Uniklinik RWTH Aachen, Aachen, Deutschland
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Affiliation as printed
Klinik für Kinderkardiologie und angeborene Herzfehler, Uniklinik RWTH Aachen, Aachen, Deutschland
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Affiliation as printed
Klinik für Kinderkardiologie und angeborene Herzfehler, Uniklinik RWTH Aachen, Aachen, Deutschland
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Affiliation as printed
Klinik für Kinderkardiologie und angeborene Herzfehler, Uniklinik RWTH Aachen, Aachen, Deutschland
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