Rest and exercise ventricular function in adults with congenital ventricular septal defects

Area of Science:

• Cardiology
• Cardiovascular Physiology

Background:

• Congenital ventricular septal defect (VSD) can lead to altered cardiac hemodynamics.
• Assessing ventricular function in VSD patients is crucial for understanding long-term outcomes.

Purpose of the Study:

• To compare rest and exercise ventricular function in VSD patients versus healthy controls.
• To evaluate the impact of VSD severity and surgical history on cardiac function.

Main Methods:

• Equilibrium gated radionuclide angiography was used to assess ventricular function.
• Nineteen healthy controls and 34 VSD patients (categorized by pulmonary-to-systemic flow ratio, prior surgery, or Eisenmenger's complex) were studied.
• Ventricular ejection fractions were measured at rest and during graded exercise.

Main Results:

• Healthy controls showed increased ejection fractions with exercise.
• VSD patients, across all groups, failed to increase ejection fractions during exercise.
• Patients with prior VSD surgery or Eisenmenger's complex had lower resting ejection fractions compared to controls.

Conclusions:

• Patients with VSD exhibit abnormal exercise-induced ventricular function.
• Surgical VSD closure does not fully restore normal ventricular function.
• Eisenmenger's complex is associated with impaired resting ventricular function.
• Chronic volume overload in VSD may detrimentally affect myocardial function.