Abstract 16817: Correlation of Right Heart Echocardiographic Quantitation With Cpet Parameters to Predict Clinical Outcomes in Patients With Congenital Right Heart Disease
Background: Adults with congenital right heart disease (ACHD) patients have a diminished exercise tolerance compared to healthy population, and abnormal peak VO2 as assessed by cardiopulmonary exercise testing (CPET)significantly predicts outcomes of heart failure and death in this population. Despite this, CPET is not as widely available as echocardiography.
Aim: We aim to correlate resting echocardiographic patterns of regional RV contractile function among ACHD patients with peak VO2 and major adverse cardiovascular events (MACE).
Methods: We retrospectively recruited 160 ACHD patients who underwent CPET at our hospital . Out of these, 94 patients had complete echocardiographic data for analysis, in studies performed within 1 year of their CPET.RV quantitative parameters measured included: Tricuspid Annular Plane Systolic Excursion (TAPSE), Tissue doppler imaging TDI (S’), RA area, RV dimensions and RV fractional area change % (FAC).These variables were correlated with peak VO2,exercise RV function by ventriculography(RV score) and MACE(heart failure, arrhythmia,death or transplantation)after CPET.
Results: The most frequent congenital pathology was Tetralogy of Fallot (35%).14% (n=13) patients had systemic right ventricles.There were 28 MACE during a median follow up of 1.3 years. FAC, TAPSE and S’ significantly correlated with peak VO2 in multivariate analysis.FAC also correlated with RV score. Decrease in FAC was associated with MACE in a continuous fashion while a cutoff value of S’< 9.5 cm/sec was also significantly associated with MACE (p=0.04,HR 2.48)(table)
Conclusion: This is a heterogenous group of ACHD lesions and routinely acquired echo RV assessment was able to broadly correlate with exercise and outcome. This differentiates us from other papers which are all lesion specific or based on strain measurements (difficult to peform and reproduce).These findings can also help prioritize patients for more sophisticated testing like CPET.
- Adult congenital right heart disease
- cardiopulmonary exercise testing
- heart failure
- exercise ventriculography
Author Disclosures: A.A. Khan: None. A.B. Bhatt: None. R. Capoulade: None. A. Stefanescu: None. A. Eisman: None. M.A. Youniss: None. J.G. Teoh: None. E. Teo: None. G.D. Lewis: None. D. Defaria Yeh: None.
- © 2015 by American Heart Association, Inc.