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Exercise testing for assessment of heart failure in adults with congenital heart disease

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Abstract

Congenital heart disease (CHD)–related heart failure is common and associated with significant morbidity, mortality, and resource utilization. In adults with CHD (ACHD), exercise limitation is often underestimated. Quantitative assessment with cardiopulmonary exercise testing (CPET) provides a comprehensive evaluation of exercise capacity and can help risk stratify patients, particularly across serial testing. CPET parameters must be interpreted within the context of the underlying anatomy, specifically for patients with either single ventricle physiology and/or cyanosis. Acknowledging differences in CPET parameters between ACHD and non-ACHD patients with heart failure are also important considerations when evaluating the overall benefit of advanced heart failure therapies. CPET testing can also guide safe exercise recommendation, including those with ACHD-related heart failure.

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Authors and Affiliations

  1. Division of Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Danielle S. Burstein

  2. Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA

    Jonathan N. Menachem

  3. Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    Alexander R. Opotowsky

  4. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Alexander R. Opotowsky

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  1. Danielle S. Burstein
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  2. Jonathan N. Menachem
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  3. Alexander R. Opotowsky
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Correspondence to Danielle S. Burstein.

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Burstein, D.S., Menachem, J.N. & Opotowsky, A.R. Exercise testing for assessment of heart failure in adults with congenital heart disease. Heart Fail Rev 25, 647–655 (2020). https://doi.org/10.1007/s10741-019-09867-1

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