Microvascular Dysfunction in Adults With Congenital Heart Disease and the Effect of Exercise Training

Microvascular Dysfunction in Adults With Congenital Heart Disease and the Effect of Exercise Training

The goal of this prospective cohort study is to deepen the understanding of the pathophysiology in adults with congenital heart disease (CHD). Through this research, the investigators aim to identify potential strategies to improve the prevention and treatment of these patients. In this context, the effects of exercise training will also be assessed. The main questions it aims to answer are:

• Is coronary microvascular dysfunction (MVD) present in adults with diverse types of CHD?
• Is peripheral MVD present in adults with diverse types of CHD?
• Are coronary and peripheral MVD correlated in adults with diverse types of CHD?
• Is microvascular function correlated with inflammation and oxidative stress in adults with diverse types of CHD?
• Are inflammation and oxidative stress correlated with ventricular function in adults with diverse types of CHD?
• Are MVD and diminished ventricular function interrelated and associated with reduced exercise capacity in adults with diverse types of CHD?
• Does exercise training in adults with CHD result in improvements in coronary and peripheral microvascular function, inflammation and oxidative stress, biventricular function, muscle strength, exercise capacity and quality of life?

For the last research question, patients were randomized to receive either conventional care or home-based aerobic and strength exercise training.

Inclusion Criteria:

• adults with congenital heart disease: as many different types of CHD as possible were incorporated
• New York Heart Association (NYHA) class I-II
• who visited the out-patient clinic at the Antwerp University Hospital

Exclusion Criteria:

• smoking
• body mass index >35 kg/m²
• professional endurance athlete
• the presence of macrovascular coronary artery disease
• diabetes mellitus
• a systemic disease (e.g., malignancies, acute and chronic inflammatory diseases in the preceding 3 months)
• a contraindication for adenosine administration.