Exercise Oscillatory Ventilation in Patients With Fontan Physiology

Circ Heart Fail. 2014 Dec 30. pii: CIRCHEARTFAILURE.114.001749. [Epub ahead of print]

Exercise Oscillatory Ventilation in Patients With Fontan Physiology.

Nathan AS1Loukas B2Moko L2Wu F3Rhodes J2Rathod RH2Systrom DM1Ubeda-Tikkanen A4Shafer K3Lewis GD5Landzberg MJ3Opotowsky AR6.

Content: Nathan et al. evaluated the prevalence and predictive value of exercise oscillatory ventilation (EOV) in patients with a single ventricle Fontan physiology. They defined EOV as regular oscillations for >60% of exercise duration with amplitude >15% of average. EOV is thought to result from aberrant respiratory auto-regulation, which becomes apparent during exercise. In patients with acquired heart failure, EOV was previously correlated with parameters of disease severity and may be used in risk stratification.

In the present study, among 253 Fontan patients, EOV was present in 37.5%. During 5.5 years of follow-up, 22 patients died or underwent transplant. EOV was predictive for shorter transplant-free survival (HR 3.9) in univariate analysis. In multivariate analysis of a composite endpoint which also included hospitalization, EOV remained predictive (HR: 2.0) after correcting for other variables. The results of this study warrant further investigation to determine the value of EOV in risk stratification and as a potential therapeutic target.