Atrial septal defect in adults: cardiopulmonary exercise capacity before and 4 months and 10 years after defect closure

J Am Coll Cardiol. 1997 May;29(6):1345-50. doi: 10.1016/s0735-1097(97)00058-2.


Objectives: The purpose of the study was to evaluate the cardiopulmonary exercise capacity and ventilatory function in adults with atrial septal defect (ASD) preoperatively and 4 months and 10 years postoperatively.

Background: Only few data are available on cardiopulmonary exercise tolerance after ASD closure, but detailed knowledge might be helpful for indication for defect closure in certain patients.

Methods: The study was performed in adult patients (mean [+/-SD] age at operation 39.9 +/- 11.5 years; left-right shunt 9.6 +/- 5.6 liters/min; pulmonary/systemic flow ratio 2.8 +/- 1.2; mean pulmonary artery pressure 18.2 +/- 6.2 mm Hg). Cardiopulmonary exercise testing was performed with a bicycle ergometer. We determined peak oxygen uptake, anaerobic threshold, performance at anaerobic threshold and maximal performance in relation to these variables in a normal group. Ventilatory function at rest was expressed by vital capacity, maximal voluntary ventilation and forced expiratory volume in 1 s.

Results: Preoperatively, ventilatory function at rest was only moderately reduced to approximately 75% to 85%. Four months postoperatively we found no significant improvement, but 10 years postoperatively ventilatory function at rest was normalized. Preoperative cardiopulmonary exercise capacity was markedly reduced to 50% to 60%; early postoperatively it was only slightly higher, but late postoperatively exercise capacity significantly improved and was completely normalized.

Conclusions: Although preoperative cardiopulmonary capacity in adult patients with nonrestrictive ASD was significantly decreased, some improvement was seen at 4 months postoperatively, with complete restitution to normal at 10 years after shunt closure.

MeSH terms

  • Adult
  • Cardiac Catheterization
  • Exercise Test
  • Exercise Tolerance / physiology*
  • Female
  • Follow-Up Studies
  • Heart Septal Defects, Atrial / diagnosis
  • Heart Septal Defects, Atrial / physiopathology*
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Male
  • Preoperative Care
  • Pulmonary Ventilation / physiology
  • Time Factors