{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:46:27Z","timestamp":1782377187350,"version":"3.54.5"},"reference-count":39,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Despite a successful repair of tetralogy of Fallot (rToF) in childhood, residual lesions are common and can contribute to impaired exercise capacity. Although both cycle ergometer and treadmill protocols are often used interchangeably these approaches have not been directly compared. In this study we examined cardiopulmonary exercise test (CPET) measurements in rToF. Methods: Inclusion criteria were clinically stable rToF patients able to perform a cardiac magnetic resonance imaging (CMR) and two CPET studies, one on the treadmill (incremental Bruce protocol) and one on the cycle ergometer (ramped protocol), within 12 months. Demographic, surgical and clinical data; functional class; QRS duration; CMR measures; CPET data and international physical activity questionnaire (IPAQ) scores of patients were collected. Results: Fifty-seven patients were enrolled (53% male, 20.5 \u00b1 7.8 years at CPET). CMR measurements included a right ventricle (RV) end-diastolic volume index of 119 \u00b1 22 mL\/m2, a RV ejection fraction (EF) of 55 \u00b1 6% and a left ventricular (LV) EF of 56 \u00b1 5%. Peak oxygen consumption (VO2)\/Kg (25.5 \u00b1 5.5 vs. 31.7 \u00b1 6.9; p &lt; 0.0001), VO2 at anaerobic threshold (AT) (15.3 \u00b1 3.9 vs. 22.0 \u00b1 4.5; p &lt; 0.0001), peak O2 pulse (10.6 \u00b1 3.0 vs. 12.1\u00b1 3.4; p = 0.0061) and oxygen uptake efficiency slope (OUES) (1932.2 \u00b1 623.6 vs. 2292.0 \u00b1 639.4; p &lt; 0.001) were significantly lower on the cycle ergometer compared with the treadmill, differently from ventilatory efficiency (VE\/VCO2) max which was significantly higher on the cycle ergometer (32.2 \u00b1 4.5 vs. 30.4 \u00b1 5.4; p &lt; 0.001). Only the VE\/VCO2 slope at the respiratory compensation point (RCP) was similar between the two methodologies (p = 0.150). Conclusions: The majority of CPET measurements differed according to the modality of testing, with the exception being the VE\/VCO2 slope at RCP. Our data suggest that CPET parameters should be interpreted according to test type; however, these findings should be validated in larger populations and in a variety of institutions.<\/jats:p>","DOI":"10.3390\/jcm13051192","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T05:10:04Z","timestamp":1708405804000},"page":"1192","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiopulmonary Exercise Testing after Surgical Repair of Tetralogy of Fallot\u2014Does Modality Matter?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6715-3472","authenticated-orcid":false,"given":"Benedetta","family":"Leonardi","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology, Cardiac Surgery and Heart Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Sollazzo","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Gentili","sequence":"additional","affiliation":[{"name":"Unit of Sport Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0587-5899","authenticated-orcid":false,"given":"Massimiliano","family":"Bianco","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elettra","family":"Pomiato","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Cardiac Surgery and Heart Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefani Silva","family":"Kikina","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Westcliff-on-Sea SS0 0RY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel Maya","family":"Wald","sequence":"additional","affiliation":[{"name":"Toronto General Hospital Research Institute (TGHRI), Toronto, ON M5G 2N2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Medicina dello Sport e Rieducazione Funzionale, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2611-8061","authenticated-orcid":false,"given":"Aurelio","family":"Secinaro","sequence":"additional","affiliation":[{"name":"Advanced Cardiothoracic Imaging Unit, Department of Imaging, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3187-0829","authenticated-orcid":false,"given":"Giulio","family":"Calcagni","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Cardiac Surgery and Heart Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1288-0108","authenticated-orcid":false,"given":"Gianfranco","family":"Butera","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Cardiac Surgery and Heart Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Unit of Sport Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Cafiero","sequence":"additional","affiliation":[{"name":"Unit of Sport Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-373X","authenticated-orcid":false,"given":"Fabrizio","family":"Drago","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Cardiac Surgery and Heart Lung Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2917","DOI":"10.1093\/eurheartj\/ehs221","article-title":"EACPR\/AHA Joint Scientific Statement. 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