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Cardiopulmonary functional capacity in Taiwanese children with atrial septal defects
Yu-Hao Xue1, I-Ching Huang1, Sheng-Hui Tuan1,2,3,4
1Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
Insights
Children with atrial septal defect (ASD) show reduced exercise capacity and cardiopulmonary function compared to healthy peers. Treatment type did not significantly impact these functional outcomes in the studied Taiwanese children.
Area of Science:
- Pediatric Cardiology
- Cardiopulmonary Exercise Physiology
- Congenital Heart Disease Research
Background:
- Existing atrial septal defect (ASD) research often focuses on morbidity (arrhythmias, heart failure) rather than post-treatment physical capacity.
- Limited studies have evaluated the cardiopulmonary function of children with ASD.
- This study utilizes the largest cohort to date, examining 122 Taiwanese children with ASD.
Purpose of the Study:
- To evaluate the cardiopulmonary functional capacity of Taiwanese children with ASD using cardiopulmonary exercise testing (CPET).
- To investigate the impact of different ASD treatment modalities (surgical closure, transcatheter closure, unrepaired) on cardiopulmonary function.
Main Methods:
- Retrospective cohort study design.
- Data collected from January 2010 to December 2021.
- Comparison of 122 ASD patients (categorized by treatment) with 244 age-, sex-, and BMI-matched healthy controls, all undergoing CPET and pulmonary function testing.
Main Results:
- ASD patients demonstrated significantly lower peak metabolic equivalent (MET), peak oxygen consumption (VO2), and peak minute ventilation compared to controls.
- Lower MET and VO2 at the anaerobic threshold (AT) were observed in the ASD group.
- No significant differences in pulmonary function tests were found between ASD patients and controls, nor among the different ASD treatment subgroups.
Conclusions:
- Taiwanese children with ASD exhibit impaired exercise capacity and cardiopulmonary performance relative to healthy children.
- The type of ASD treatment (surgical, transcatheter, or unrepaired) did not lead to significant differences in CPET or pulmonary function test results.
Background:
Most existing studies measure atrial septal defect (ASD) outcomes based on morbidity rates such as atrial arrhythmias and heart failure rather than the functional assessment of physical capacity postprocedure. Few studies have evaluated cardiopulmonary function in ASD children. This study represents the largest sample population in the current research, encompassing a total of 122 Taiwanese children with ASD who had undergone treatment, to evaluate cardiopulmonary functional capacity through the implementation of cardiopulmonary exercise testing (CPET), and to investigate whether variations in treatment may impact their cardiopulmonary function.
Methods:
This is a retrospective cohort study with the data collected from January 2010 to December 2021. All patients and controls (age-, sex-, and body mass index-matched) underwent CPET and pulmonary function testing.
Results:
In total, 122 ASD patients (surgically closed ASDs 27, transcatheter-closed ASDs 48, and follow-up unrepaired ASD 47) and 244 healthy controls were recruited. The ASD group exhibited lower peak metabolic equivalent (MET), peak oxygen consumption (VO 2 , p < 0.001), and peak minute ventilation ( p = 0.028) along with MET and VO 2 at the anaerobic threshold (AT) ( p = 0.012) compared to the control group. No statistically significant differences were observed in the pulmonary function test. Among surgically closed, transcatheter closed and unrepaired ASD subgroups, no significant variances were seen in CPET and pulmonary function tests.
Conclusion:
Taiwanese ASD children exhibited diminished exercise capacity and cardiopulmonary performance compared to their healthy counterparts. Differences among specific ASD treatments in cardiopulmonary tests were non-significant.
