Prior to the 1990s, d-TGA was palliated with the atrial switch procedure resulting in a systemic right ventricle associated with significant long-term morbidity and mortality. Determining the optimal timing of heart transplantation (HT) in these patients has been difficult. While cardiopulmonary exercise testing (CPET) is commonly used to try and risk stratify these patients, traditional exercise parameters have lacked the sensitivity and specificity to assess long-term risk. We sought to assess changes in exercise parameters over time in order to determine if any CPET parameter or combination of parameters could reliably identify risk for adverse outcome in this patient group. A retrospective review of serial CPET for 40 patients over 17 years was completed. Patients with adverse event within 6 months prior to CPET were noted. CPET parameters were compared and linear mixed model regression with repeated measures was performed on serial tests for longitudinal assessment. The linear mixed model regression identified OUES indexed to BSA to be the most sensitive parameter in identifying patients at risk of adverse event and became a stronger predictor of adverse event when combined with peak heart rate. CPET is useful in identifying patients with atrial switch at increased risk of adverse outcome. Indexed OUES and peak heart rate are better prognostic indicators than VO₂ and VE/VCO₂.

在 1990 年代之前，d-TGA 通过心房转换程序得到缓解，导致全身性右心室与显着的长期发病率和死亡率相关。在这些患者中确定心脏移植 (HT) 的最佳时机一直很困难。虽然心肺运动测试 (CPET) 通常用于尝试对这些患者进行风险分层，但传统的运动参数缺乏评估长期风险的敏感性和特异性。我们试图评估运动参数随时间的变化，以确定是否有任何 CPET 参数或参数组合可以可靠地识别该患者组的不良结果风险。完成了对 40 名患者超过 17 年的连续 CPET 的回顾性审查。记录在 CPET 前 6 个月内发生不良事件的患者。比较 CPET 参数，并在纵向评估的系列测试中进行重复测量的线性混合模型回归。线性混合模型回归确定了与 BSA 挂钩的 OUES 是识别有不良事件风险的患者的最敏感参数，并在与峰值心率相结合时成为不良事件的更强预测因子。CPET 可用于识别不良结局风险增加的心房转换患者。指数 OUES 和峰值心率是比 VO 更好的预后指标 线性混合模型回归确定了与 BSA 挂钩的 OUES 是识别有不良事件风险的患者的最敏感参数，并在与峰值心率相结合时成为不良事件的更强预测因子。CPET 可用于识别不良结局风险增加的心房转换患者。指数 OUES 和峰值心率是比 VO 更好的预后指标 线性混合模型回归确定了与 BSA 挂钩的 OUES 是识别有不良事件风险的患者的最敏感参数，并在与峰值心率相结合时成为不良事件的更强预测因子。CPET 可用于识别不良结局风险增加的心房转换患者。指数 OUES 和峰值心率是比 VO 更好的预后指标₂和 VE/VCO ₂。