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Open Access Research article

Serial exercise testing in children, adolescents and young adults with Senning repair for transposition of the great arteries

Roselien Buys1*, Werner Budts2, Tony Reybrouck13, Marc Gewillig4 and Luc Vanhees1

Author Affiliations

1 Department of Rehabilitation Sciences, Research Center for Cardiovascular and Respiratory Rehabilitation, KULeuven, Tervuursevest 101, Leuven, 3001, Belgium

2 Department of Cardiology, University Hospital Gasthuisberg, Herestraat 49, Leuven, 3000, Belgium

3 Department of Cardiovascular Rehabilitation, University Hospital Gasthuisberg, Herestraat 49, Leuven, 3000, Belgium

4 Department of Pediatric Cardiology, University Hospital Gasthuisberg, Herestraat 49, Leuven, 3000, Belgium

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BMC Cardiovascular Disorders 2012, 12:88  doi:10.1186/1471-2261-12-88

Published: 15 October 2012

Abstract

Background

Patients with Senning repair for complete transposition of the great arteries (d-TGA) show an impaired exercise tolerance. Our aim was to investigate changes in exercise capacity in children, adolescents and adults with Senning operation.

Methods

Peak oxygen uptake (peak VO2), oxygen pulse and heart rate were assessed by cardiopulmonary exercise tests (CPET) and compared to normal values. Rates of change were calculated by linear regression analysis. Right ventricular (RV) function was assessed by echocardiography.

Results

Thirty-four patients (22 male) performed 3.5 (range 3–6) CPET with an interval of ≥ 6 months. Mean age at first assessment was 16.4 ± 4.27 years. Follow-up period averaged 6.8 ± 2 years. Exercise capacity was reduced (p<0.0005) and the decline of peak VO2 (−1.3 ± 3.7 %/year; p=0.015) and peak oxygen pulse (−1.4 ± 3.0 %/year; p=0.011) was larger than normal, especially before adulthood and in female patients (p<0.01). During adulthood, RV contractility changes were significantly correlated with the decline of peak oxygen pulse (r= −0.504; p=0.047).

Conclusions

In patients with Senning operation for d-TGA, peak VO2 and peak oxygen pulse decrease faster with age compared to healthy controls. This decline is most obvious during childhood and adolescence, and suggests the inability to increase stroke volume to the same extent as healthy peers during growth. Peak VO2 and peak oxygen pulse remain relatively stable during early adulthood. However, when RV contractility decreases, a faster decline in peak oxygen pulse is observed.

Keywords:
Exercise capacity; Transposition of the great arteries; Senning repair; Median term follow-up