Background: The role of cardiopulmonary exercise testing (CPET) in predicting major adverse cardiovascular events (MACE) in people with congenital heart disease (ConHD) is unknown. Design: A systematic review with meta-analysis was conducted to report the associations between CPET parameters and MACE in people with ConHD. Methods: Electronic databases were systematically searched on the 30th of April 2020 for eligible publications. Two authors independently screened publications for inclusion, extracted study data, and performed risk of bias assessment. Primary meta-analysis pooled univariate hazard ratios (HR) across studies. Results: A total of 34 studies (18,335 participants; 26.2 ± 10.1 years; 54% ± 16% male) were pooled into meta-analyses. More than 20 different CPET prognostic factors were reported across 6 ConHD types. Of the 34 studies included in the meta-analyses, 10 (29%), 23 (68%), and 1 (3%) were judged as a low, medium, and high risk of bias, respectively. Primary univariate meta-analysis showed consistent evidence that improved peak and submaximal CPET measures are associated with a reduce risk of MACE (overall HR: 0.93, 95% CI: 0.91 to 0.94). This association was supported by a secondary meta-analysis of multivariate estimates and individual studies that could not be numerically pooled. Conclusion: Various maximal and submaximal CPET measures are prognostic of MACE across a variety of ConHD diagnoses. Further well conducted prospective multicentre cohort studies are needed to confirm these findings.
Physiology 2021 (2021) Proc Physiol Soc 48, PC008
Poster Communications: The role of cardiopulmonary exercise testing (CPET) in predicting mortality and morbidity in people with congenital heart disease: a systematic review and meta-analysis.
Curtis Wadey1, Max Weston1, 2, Dan-Mihai Dorobantu1, 3, Guido Pieles4, 5, Graham Stuart4, 6, Alan Barker1, Rod Taylor7, Craig Williams1
1 Children's Health & Exercise Research Centre (CHERC), College of Life and Environmental Sciences, University of Exeter, Exeter, UK., Exeter, United Kingdom 2 School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia, Brisbane, Australia 3 School of Population Health Sciences, University of Bristol, Bristol, UK., Bristol, United Kingdom 4 National Institute for Health Research (NIHR) Cardiovascular Biomedical Research Centre, Bristol Heart Institute, Bristol, UK., Bristol, United Kingdom 5 Institute of Sport Exercise and Health (ISEH), University College London, UK, London, United Kingdom 6 Bristol Congenital Heart Centre, The Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, UK., Bristol, United Kingdom 7 MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK., Glasgow, United Kingdom
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Where applicable, experiments conform with Society ethical requirements.