{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T11:14:44Z","timestamp":1794568484857,"version":"4.9.1"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Recently, the number of patients with congenital heart diseases reaching adulthood has been progressively increasing in developed countries, and new issues are emerging: the evaluation of their capacity to cope with physical activity and whether this knowledge can be used to optimize medical management. A symptom-limited cardiopulmonary exercise test has proven to be an essential tool, because it can objectively evaluate the functional cardiovascular capacity of these patients, identify the pathological mechanisms of the defect (circulatory failure, shunts, and\/or pulmonary hypertension), and help prescribe an individualized rehabilitation program when needed. The common findings on cardiopulmonary exercise testing in patients with congenital heart diseases are a reduced peak V.o2, an early anaerobic threshold, a blunted heart rate response, a reduced increase of Vt, and an increased V.e\/V.co2. All these measures suggest common pathophysiological abnormalities: (1) a compromised exercise capacity from anomalies affecting the heart, vessels, lungs, or muscles; (2) chronotropic incompetence secondary to cardiac autonomic dysfunction or \u03b2-blockers and antiarrhythmic therapy; and (3) ventilatory inefficiency caused by left-heart failure with pulmonary congestion, pulmonary hypertension, pulmonary obstructive vascular disease, or cachexia. Most of these variables also have prognostic significance. For these patients, cardiopulmonary exercise testing allows evaluation and decisions affecting lifestyle and therapeutic interventions.<\/jats:p>","DOI":"10.1513\/annalsats.201611-876fr","type":"journal-article","created":{"date-parts":[[2017,4,4]],"date-time":"2017-04-04T17:01:11Z","timestamp":1491325271000},"page":"S93-S101","source":"Crossref","is-referenced-by-count":50,"title":["Cardiopulmonary Exercise Testing in Adult Congenital Heart Disease"],"prefix":"10.1093","volume":"14","author":[{"given":"Valentina","family":"Mantegazza","sequence":"first","affiliation":[{"name":"Heart Failure Unit, Istituto di Ricerca e Cura a Carattere Scientifico Centro Cardiologico Monzino, Universit\u00e0 degli Studi di Milano, Milan, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Apostolo","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Istituto di Ricerca e Cura a Carattere Scientifico Centro Cardiologico Monzino, Universit\u00e0 degli Studi di Milano, Milan, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Hager","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,7,1]]},"reference":[{"key":"2026020403045631800_bib1","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1007\/s00246-015-1129-1","article-title":"Exercise capacity in children and adolescents with corrected congenital heart disease","volume":"36","author":"Feltez","year":"2015","journal-title":"Pediatr Cardiol"},{"key":"2026020403045631800_bib2","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/S0195-668X(03)00005-8","article-title":"Congenital heart disease: the original heart failure syndrome","volume":"24","author":"Bolger","year":"2003","journal-title":"Eur Heart J"},{"key":"2026020403045631800_bib3","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/j.jacc.2006.05.051","article-title":"Heart rate response during exercise predicts survival in adults with congenital heart disease","volume":"48","author":"Diller","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2026020403045631800_bib4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1586\/14779072.2014.919223","article-title":"Cardiopulmonary exercise testing in adults with congenital heart disease","volume":"12","author":"Khan","year":"2014","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2026020403045631800_bib5","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.recesp.2011.05.007","article-title":"Cardiopulmonary stress testing in children who have had congenital heart disease surgery: physical exercise recommendations during school hours [in Spanish]","volume":"64","author":"Serra-Grima","year":"2011","journal-title":"Rev Esp Cardiol"},{"key":"2026020403045631800_bib6","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.hfc.2013.09.012","article-title":"Exercise physiology and testing in adult patients with congenital heart disease","volume":"10","author":"Buber","year":"2014","journal-title":"Heart Fail Clin"},{"key":"2026020403045631800_bib7","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1136\/hrt.2010.213579","article-title":"Generalised muscle weakness in young adults with congenital heart disease","volume":"97","author":"Greutmann","year":"2011","journal-title":"Heart"},{"key":"2026020403045631800_bib8","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1093\/eurheartj\/ehi396","article-title":"The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a 5 year follow-up period. 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