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Transthoracic echocardiographic and cardiopulmonary exercise testing parameters in Eisenmenger’s syndrome

Association with six-minute walk test distance

Transthorakale echokardiographische und kardiopulmonale Belastungstestparameter bei Eisenmenger-Syndrom

Zusammenhang mit der 6-min-Gehtest-Strecke

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Abstract

Objective

The six-minute walk test (6MWT) evaluates the functional exercise capacity in patients with cardiopulmonary disease. We aimed to investigate the association between 6MWT distance and transthoracic echocardiographic (TTE) findings as well as cardiopulmonary exercise testing (CPET) parameters in Eisenmenger’s syndrome (ES) patients waiting for heart–lung transplantation on their initial admission to our center.

Patients and methods

A total of 23 patients with ES (12 women, 11 men; mean age, 28.2 ± 8.1 years) were included in the study. The correlation between 6MWT distance and CPET and TTE findings was retrospectively analyzed.

Results

The most frequent underlying heart diseases were ventricular septal defect (VSD) with complex congenital heart disease (n = 10, 43 %) and isolated VSD (n = 7, 30 %). The 6MWT distance was 349.7 ± 77.4 m in the study group. An inverse correlation was found between 6MWT distance and systolic pulmonary arterial pressure (SPAP) measured with TTE (r = − 0.445; p = 0.03). All patients underwent CPET at the first visit. Mean VO2 max was 14.9 ± 3.3 ml/kg/min and the VE/VCO2 rate was 50.4 ± 9.2 %. No significant correlation was observed between 6MWT and CPET findings. SPAP, which did not display any correlation with CPET findings, was the only independent predictor of 6MWT distance.

Conclusion

We suggest that 6MWT distance may be more suitable than CPET in the follow-up of ES patients. Further prospective, randomized, controlled trials are necessary to make more robust interpretations of this issue.

Zusammenfassung

Ziel

Mit dem 6-min-Gehtest (6-MWT) wird die funktionelle Belastungskapazität bei Patienten mit kardiopulmonalen Erkrankungen untersucht. Ziel der vorliegenden Studie war es, den Zusammenhang zwischen 6-MWT-Strecke und dem Befund der transthorakalen Echokardiographie (TTE) sowie kardiopulmonalen Belastungstest(CPET)-Parametern bei Patienten mit Eisenmenger-Syndrom (ES), die auf eine Herz-Lungen-Transplantation warten, im Rahmen der Erstaufnahme in der Klinik zu ermitteln.

Methoden

Insgesamt wurden 23 ES-Patienten (12 Frauen, 11 Männer, Durchschnittsalter: 28,2 ± 8,1 Jahre) in die Studie aufgenommen. Die Korrelation von 6-MWT-Strecke, CPET und TTE-Befund wurde retrospektiv ausgewertet.

Ergebnisse

Die häufigsten zugrunde liegenden Herzerkrankungen waren ein Ventrikelseptumdefekt (VSD) mit komplexer angeborener Herzerkrankung (n = 10; 43 %) und ein isolierter VSD (n = 7; 30 %). Die 6-MWT-Strecke betrug 349,7 ± 77,4 m in der Gruppe der Studienteilnehmer. Zwischen der 6-MWT-Strecke und dem mittels TTE gemessenen systolischen Pulmonalarteriendruck (SPAP; r = − 0,445; p = 0,03) wurde eine inverse Korrelation festgestellt. Ein CPET wurde bei allen Patienten im Rahmen der Erstuntersuchung durchgeführt. Die durchschnittliche VO2 max lag bei 14,9 ± 3,3 ml/kg/min und die VE/VCO2-Rate bei 50,4 ± 9,2 %. Es wurde keine signifikante Korrelation zwischen dem 6-MWT und den CPET-Befunden ermittelt. Der SPAP, der keine Korrelation mit den CPET-Befunden aufwies, war der einzige unabhängige Prädiktor der 6-MWT-Strecke.

Schlussfolgerung

Nach Meinung der Autoren ist die 6-MWT-Strecke möglicherweise besser für die Nachuntersuchung von ES-Patienten geeignet als der CPET. Weitere prospektive randomisierte kontrollierte Studien sind erforderlich, um diese Frage genauer beantworten zu können.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Cardiology, Adnan Menderes University, 09100, Aydin, Turkey

    H. Gungor MD

  2. Department of Cardiovascular Surgery, Ege University, Izmir, Turkey

    M. Fatih Ayik, C. Engin, T. Yagdi, Y. Atay & M. Ozbaran

  3. Department of Cardiology, Ege University, Izmir, Turkey

    S. Nalbantgil

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  1. H. Gungor MD
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  2. M. Fatih Ayik
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  3. C. Engin
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  4. T. Yagdi
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  5. Y. Atay
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  7. S. Nalbantgil
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Correspondence to H. Gungor MD.

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Gungor, H., Fatih Ayik, M., Engin, C. et al. Transthoracic echocardiographic and cardiopulmonary exercise testing parameters in Eisenmenger’s syndrome. Herz 39, 633–637 (2014). https://doi.org/10.1007/s00059-013-3880-5

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  • DOI: https://doi.org/10.1007/s00059-013-3880-5

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