This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Musewe, N. N. Articles by Canny, G. J. Search for Related Content PubMed PubMed Citation Articles by Musewe, N. N. Articles by Canny, G. J.

Circulation, Vol 77, 1055-1061, Copyright © 1988 by American Heart Association

ARTICLES

Cardiopulmonary adaptation at rest and during exercise 10 years after Mustard atrial repair for transposition of the great arteries

NN Musewe, J Reisman, LN Benson, D Wilkes, H Levison, RM Freedom, GA Trusler and GJ Canny
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Discordance exists between apparently reduced systemic right ventricular function and the reported asymptomatic state of many patients after atrial repair for transposition of the great arteries. To evaluate this clinical observation, cardiopulmonary response to exercise in 17 asymptomatic patients with no significant postoperative hemodynamic abnormalities was assessed by upright bicycle ergometry according to a modified Jomes protocol 11.5 +/- 1.5 years after Mustard atrial repair. Seventeen age- and sex-matched normal adolescents constituted the control group. Incremental exercise was performed to determine maximum work capacity, heart rate, blood pressure, oxygen saturation, and minute ventilation. Cardiac output was computed at rest and during steady-state exercise by a carbon dioxide rebreathing method at 50% of the maximum workload achieved during incremental exercise. Height and weight were similar in patients and controls (p greater than .05). Resting pulmonary function variables were normal in all subjects. At peak exercise, respiratory quotient was greater than 1 in both patients and controls (1.12 +/- 0.09 and 1.09 +/- 0.08 respectively, p greater than .05). Patients achieved a lower peak heart rate (172 +/- 14 vs 185 +/- 11 beats/min, p less than .01), lower maximum work capacity (2.3 +/- 0.6 vs 3.3 +/- 0.7 W/kg, p less than .01). The ratio of minute ventilation at peak exercise to maximum resting voluntary ventilation was normal (less than or equal to 80%) in both groups. The ventilatory equivalent for oxygen was similar at rest, but significantly higher in patients than in control subjects at peak exercise (42 +/- 7 vs 36 +/- 5, p less than .006).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				A. Dore, C. Houde, K.-L. Chan, A. Ducharme, P. Khairy, M. Juneau, F. Marcotte, and L.-A. Mercier Angiotensin Receptor Blockade and Exercise Capacity in Adults With Systemic Right Ventricles: A Multicenter, Randomized, Placebo-Controlled Clinical Trial Circulation, October 18, 2005; 112(16): 2411 - 2416. [Abstract] [Full Text] [PDF]

				M A Gatzoulis, J Walters, P R McLaughlin, N Merchant, G D Webb, and P Liu Late arrhythmia in adults with the Mustard procedure for transposition of great arteries: a surrogate marker for right ventricular dysfunction? Heart, October 1, 2000; 84(4): 409 - 415. [Abstract] [Full Text]

				J. L. Myers Transposition of the Great Arteries Ann. Thorac. Surg., March 1, 1997; 63(3): 895 - 898. [Full Text]

				F. Meijboom, A. Szatmari, J. W. Deckers, E. M. W. J. Utens, J. R. T. C. Roelandt, E. Bos, and J. Hess LONG-TERM FOLLOW-UP (10 TO 17 YEARS) AFTER MUSTARD REPAIR FOR TRANSPOSITION OF THE GREAT ARTERIES J. Thorac. Cardiovasc. Surg., June 1, 1996; 111(6): 1158 - 1168. [Abstract] [Full Text]

				C. H. Lorenz, E. S. Walker, T. P. Graham Jr, and T. A. Powers Right Ventricular Performance and Mass by Use of Cine MRI Late After Atrial Repair of Transposition of the Great Arteries Circulation, November 1, 1995; 92(9): 233 - 239. [Abstract] [Full Text]