{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T16:55:49Z","timestamp":1732035349629},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,1]],"date-time":"2014-12-01T00:00:00Z","timestamp":1417392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,12,1]],"date-time":"2014-12-01T00:00:00Z","timestamp":1417392000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:p>Patients with early repair of an isolated atrial septal defect (ASD) are expected to have unremarkable right ventricular (RV) and pulmonary circulation physiology. Some studies, however, suggest persistent functional impairment. We aimed to examine the role of abnormal RV and pulmonary vascular response to exercise in patients who had undergone ASD closure. Using a previously published data set, we reviewed invasive exercise cardiopulmonary testing with right\u2010sided hemodynamic data for 12 asymptomatic patients who had undergone ASD closure. The 5 (42%) patients with impaired maximal oxygen uptake (<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/pul2bf00863-math-0001.png\" xlink:title=\"urn:x-wiley:20458940:media:pul2bf00863:pul2bf00863-math-0001\" \/>o<jats:sub>2max<\/jats:sub>) were older and exhibited a lower peak cardiac index (5.6 \u00b1 0.8 vs. 9.0 \u00b1 1.2\u00a0L\/min\/m<jats:sup>2<\/jats:sup>; <jats:italic>P<\/jats:italic> =. 005) because of abnormal stroke volume augmentation (+3.2 \u00b1 3.9 vs. +17.4 \u00b1 10.2\u00a0mL\/m<jats:sup>2<\/jats:sup>; <jats:italic>P<\/jats:italic> =. 02). While all resting hemodynamic variables were similar, patients with low <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/pul2bf00863-math-0002.png\" xlink:title=\"urn:x-wiley:20458940:media:pul2bf00863:pul2bf00863-math-0002\" \/>o<jats:sub>2max<\/jats:sub> tended to have abnormal total pulmonary vascular resistance change during exercise (+11% \u00b1 41% vs. ?28% \u00b1 26%; <jats:italic>P<\/jats:italic> =. 06) and had a steeper relation between mean pulmonary arterial pressure and cardiac index (5.8 \u00b1 0.6 vs. 2.2 \u00b1 0.1\u00a0L\/min\/m<jats:sup>2<\/jats:sup>; <jats:italic>P<\/jats:italic> =. 02). The increase in peak mean RV power during exercise was also significantly lower in the impaired\u2010<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/pul2bf00863-math-0003.png\" xlink:title=\"urn:x-wiley:20458940:media:pul2bf00863:pul2bf00863-math-0003\" \/>o<jats:sub>2max<\/jats:sub> patients (4.7 \u00b1 1.6 vs. 7.6 \u00b1 2.1\u00a0J\/s; <jats:italic>P<\/jats:italic> =. 04). As described in the original study, despite normal resting hemodynamics, a subset of asymptomatic patients with repaired ASD had diminished exercise capacity. Our analysis allows us to conclude that this is due to a combination of abnormal pulmonary vascular response to exercise and impaired RV function.<\/jats:p>","DOI":"10.1086\/678509","type":"journal-article","created":{"date-parts":[[2014,10,28]],"date-time":"2014-10-28T21:51:06Z","timestamp":1414533066000},"page":"630-637","update-policy":"http:\/\/dx.doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Impaired Exercise Capacity following Atrial Septal Defect Closure: An Invasive Study of the Right Heart and Pulmonary Circulation"],"prefix":"10.1002","volume":"4","author":[{"given":"M\u00e1rio","family":"Santos","sequence":"first","affiliation":[{"name":"Department of Physiology and Cardiothoracic Surgery Cardiovascular Research and Development Unit Faculty of Medicine University of Porto Porto Portugal"}]},{"given":"David","family":"Systrom","sequence":"additional","affiliation":[{"name":"Department of Medicine Brigham and Women's Hospital Boston Massachusetts USA"}]},{"given":"Stephen E.","family":"Epstein","sequence":"additional","affiliation":[{"name":"MedStar Heart Institute Washington Hospital Center Washington, DC USA"}]},{"given":"Anitha","family":"John","sequence":"additional","affiliation":[{"name":"MedStar Heart Institute Washington Hospital Center Washington, DC USA"},{"name":"Department of Cardiology Children's National Medical Center Washington, DC USA"}]},{"given":"George","family":"Ruiz","sequence":"additional","affiliation":[{"name":"MedStar Heart Institute Washington Hospital Center Washington, DC USA"}]},{"given":"Michael J.","family":"Landzberg","sequence":"additional","affiliation":[{"name":"Department of Medicine Brigham and Women's Hospital Boston Massachusetts USA"},{"name":"Department of Cardiology Boston Children's Hospital Boston Massachusetts USA"}]},{"given":"Alexander R.","family":"Opotowsky","sequence":"additional","affiliation":[{"name":"Department of Medicine Brigham and Women's 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