{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:32:26Z","timestamp":1787509946811,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Ventricular septal defects (VSD), when treated correctly in childhood, are considered to have great prognoses, and the majority of patients are discharged from follow\u2010up when entering their teens. Young adults were previously found to have poorer functional capacity than healthy peers, but the question remains whether functional capacity degenerates further with age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A group of 30 patients with surgically closed VSDs (51\u00b18\u00a0years) with 30 matched, healthy control participants (52\u00b19\u00a0years) and a group of 30 patients with small unrepaired VSDs (55\u00b112\u00a0years) and 30 matched control participants (55\u00b110\u00a0years) underwent cardiopulmonary exercise testing using an incremental workload protocol and noninvasive gas measurement. Peak oxygen uptake was lower in participants with closed VSDs than matched controls (24\u00b17 versus 34\u00b19\u00a0mL\/min per kg,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01) and with unrepaired VSDs than matched controls (26\u00b15 versus 32\u00b18\u00a0mL\/min per kg,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01). Patients demonstrated lower oxygen uptake from exercise levels at 20% of maximal workload compared with respective control groups (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01). Peak ventilation was lower in patients with surgically closed VSDs than control participants (1.0\u00b10.3 versus 1.4\u00b10.4\u00a0L\/min per kg,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01) but similar in patients with unrepaired VSDs and control participants (\n                      <jats:italic>P<\/jats:italic>\n                      =0.14). Exercise capacity was 29% lower in older patients with surgically closed VSDs than healthy peers, whereas younger patients with surgically closed VSDs previously demonstrated 18% lower capacity compared with peers. Older patients with unrepaired VSDs reached 21% lower exercise capacity, whereas younger patients with unrepaired VSDs previously demonstrated 17% lower oxygen uptake than healthy peers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with VSDs demonstrate poorer exercise capacity than healthy peers. The difference between patients and control participants increased with advancing age\u2014and increased most in patients with operated VSDs\u2014compared with previous findings in younger patients. Results warrant continuous follow\u2010up for these simple defects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.015956","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T05:00:14Z","timestamp":1600837214000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Functional Capacity Past Age 40 in Patients With Congenital Ventricular Septal Defects"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-3807","authenticated-orcid":false,"given":"Marie","family":"Maagaard","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Eckerstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8107-9157","authenticated-orcid":false,"given":"Nicolai","family":"Boutrup","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibeke E.","family":"Hjortdal","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"},{"name":"Department of Clinical Medicine Copenhagen University Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.10.057"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.11.032"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304372"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01272-4"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.10.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq249"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0828-282X(10)70352-4"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.10.009"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.05.071"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951117000877"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.06.097"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.06.109"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951113002084"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.10.086"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezw420"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.02.014"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951118001361"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.02.055"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.09.047"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2009.12.007"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000603"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000078924.61453.FB"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181e52e69"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1986.60.6.2020"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.02.069"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)01270-9"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2001-9918"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2015-310154"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.01.024"},{"key":"e_1_3_2_32_2","first-page":"574","article-title":"Reduced biventricular contractility during exercise in adults with small, unrepaired ventricular septal defects: an echocardiographic study","volume":"1","author":"Maagaard M","year":"2020","unstructured":"Maagaard M, Heiberg J, Redington AN, Hjortdal VE. 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