Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation Study

Background Peak oxygen consumption (peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$) is routinely measured in people who have congenital heart disease and is reported as a percentage of predicted value, based upon age‐ and sex‐matched normative reference values (NRVs). This study aimed to identify whi...

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Main Authors: Curtis A. Wadey, Owen W. Tomlinson, Alan R. Barker, A. Graham Stuart, Derek L. Tran, Karina Laohachai, Julian Ayer, Robert G. Weintraub, Rachael Cordina, Craig A. Williams
Format: Article
Language:English
Published: Wiley 2024-09-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.123.034035
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author Curtis A. Wadey
Owen W. Tomlinson
Alan R. Barker
A. Graham Stuart
Derek L. Tran
Karina Laohachai
Julian Ayer
Robert G. Weintraub
Rachael Cordina
Craig A. Williams
author_facet Curtis A. Wadey
Owen W. Tomlinson
Alan R. Barker
A. Graham Stuart
Derek L. Tran
Karina Laohachai
Julian Ayer
Robert G. Weintraub
Rachael Cordina
Craig A. Williams
author_sort Curtis A. Wadey
collection DOAJ
description Background Peak oxygen consumption (peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$) is routinely measured in people who have congenital heart disease and is reported as a percentage of predicted value, based upon age‐ and sex‐matched normative reference values (NRVs). This study aimed to identify which NRVs are being used, assess whether NRVs are being applied appropriately, and evaluate if recommended NRVs are valid when applied to people with congenital heart disease. Methods and Results A systematic scoping review identified studies that reported peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ percentage of predicted value in people with congenital heart disease. A modified risk of bias tool evaluated the included studies. Forty‐five studies reported peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ percentage of predicted value, and only 21 (47%) studies described or provided a reference on how their percentage of predicted value was calculated. The most cited NRVs were from Wasserman (n=12) and Cooper and Weiler‐Ravell (n=7). Risk of bias analysis judged 63% of studies as having some concerns. The NRVs recommended by the American Heart Association were applied to participants with a Fontan circulation (n=70; aged 26.5±6.4 years; 59% women) to examine validity. Predicted peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ values from the Wasserman NRV was not significantly associated to measured peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ values (men: b=0.31, R2≤0.01; women: b=0.07, R2=0.02). Conclusions Numerous NRVs have been applied to individuals with congenital heart disease and are often poorly reported and inappropriately matched to participants. The Wasserman NRV was the most cited but showed poor validity when applied to a Fontan cohort.
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spelling doaj-art-064d82cdad4a492d986d1803cd1040242024-11-28T12:39:45ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-09-01131710.1161/JAHA.123.034035Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation StudyCurtis A. Wadey0Owen W. Tomlinson1Alan R. Barker2A. Graham Stuart3Derek L. Tran4Karina Laohachai5Julian Ayer6Robert G. Weintraub7Rachael Cordina8Craig A. Williams9Department of Public Health and Sport Science, Children’s Health & Exercise Research Centre (CHERC), Faculty of Health and Life Sciences University of Exeter United KingdomDepartment of Public Health and Sport Science, Children’s Health & Exercise Research Centre (CHERC), Faculty of Health and Life Sciences University of Exeter United KingdomDepartment of Public Health and Sport Science, Children’s Health & Exercise Research Centre (CHERC), Faculty of Health and Life Sciences University of Exeter United KingdomBristol Congenital Heart Centre, The Bristol Heart Institute University Hospitals Bristol NHS Foundation Trust Bristol United KingdomCentral Clinical School University of Sydney Camperdown New South Wales AustraliaCentral Clinical School University of Sydney Camperdown New South Wales AustraliaCentral Clinical School University of Sydney Camperdown New South Wales AustraliaDepartment of Cardiology Royal Children’s Hospital Melbourne AustraliaCentral Clinical School University of Sydney Camperdown New South Wales AustraliaDepartment of Public Health and Sport Science, Children’s Health & Exercise Research Centre (CHERC), Faculty of Health and Life Sciences University of Exeter United KingdomBackground Peak oxygen consumption (peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$) is routinely measured in people who have congenital heart disease and is reported as a percentage of predicted value, based upon age‐ and sex‐matched normative reference values (NRVs). This study aimed to identify which NRVs are being used, assess whether NRVs are being applied appropriately, and evaluate if recommended NRVs are valid when applied to people with congenital heart disease. Methods and Results A systematic scoping review identified studies that reported peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ percentage of predicted value in people with congenital heart disease. A modified risk of bias tool evaluated the included studies. Forty‐five studies reported peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ percentage of predicted value, and only 21 (47%) studies described or provided a reference on how their percentage of predicted value was calculated. The most cited NRVs were from Wasserman (n=12) and Cooper and Weiler‐Ravell (n=7). Risk of bias analysis judged 63% of studies as having some concerns. The NRVs recommended by the American Heart Association were applied to participants with a Fontan circulation (n=70; aged 26.5±6.4 years; 59% women) to examine validity. Predicted peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ values from the Wasserman NRV was not significantly associated to measured peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ values (men: b=0.31, R2≤0.01; women: b=0.07, R2=0.02). Conclusions Numerous NRVs have been applied to individuals with congenital heart disease and are often poorly reported and inappropriately matched to participants. The Wasserman NRV was the most cited but showed poor validity when applied to a Fontan cohort.https://www.ahajournals.org/doi/10.1161/JAHA.123.034035cardiorespiratory fitnesscongenital heart diseaseCPET
spellingShingle Curtis A. Wadey
Owen W. Tomlinson
Alan R. Barker
A. Graham Stuart
Derek L. Tran
Karina Laohachai
Julian Ayer
Robert G. Weintraub
Rachael Cordina
Craig A. Williams
Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiorespiratory fitness
congenital heart disease
CPET
title Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation Study
title_full Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation Study
title_fullStr Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation Study
title_full_unstemmed Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation Study
title_short Percentage Predicted Peak Oxygen Consumption in People With Fontan Circulation: A Rapid Systematic Scoping Review and Validation Study
title_sort percentage predicted peak oxygen consumption in people with fontan circulation a rapid systematic scoping review and validation study
topic cardiorespiratory fitness
congenital heart disease
CPET
url https://www.ahajournals.org/doi/10.1161/JAHA.123.034035
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