Exercise Test Assesses Risk in Congenital Heart Disease

Blunted heart rate increase during exercise signals increased risk

FRIDAY, Sept. 22 (HealthDay News) -- Exercise testing can identify a subpopulation of patients with adult congenital heart disease (ACHD) that are at increased risk for death, according to a report in the Sept. 19 Journal of the American College of Cardiology.

Michael A. Gatzoulis, M.D., Ph.D., of Royal Brompton Hospital in London, U.K., and colleagues asked whether chronotropic incompetence -- a blunted increase in heart rate during exercise -- can predict mortality in ACHD patients as it does for patients with acquired heart disease.

Lower values for heart rate reserve, peak heart rate, heart rate recovery after exercise and peak oxygen consumption were predictive of higher mortality in 727 ACHD patients tested. In addition, heart rate reserve in combination with peak oxygen consumption identified a subpopulation with a 3.8-fold increase in mortality.

The development of risk stratification methods for ACHD such as exercise testing will help direct resources to those at the greatest risk, the authors suggest. "Exercise testing should be considered as part of the routine assessment of adults with congenital heart disease," they conclude.

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