Right ventricular function, exercise capacity and quality of life in adults with congenital heart disease and the effect of a home-based exercise program

Background Right ventricular (RV) function is crucial in the prognosis of adults with congenital heart disease (ACHD). However, its relationship with exercise capacity (EC) and quality of life (QoL) in ACHD remains underexplored. Despite the established benefits of physical activity in CHD, there is limited knowledge regarding the cardiac effects of exercise training in ACHD. Aim To assess the relationship between RV function, comprehensively evaluated using two-dimensional multiplane echocardiography (2D MPE), and both EC and QoL in adults with various types of CHD. Additionally, to investigate the effect of a 16-week home-based aerobic and strength exercise program on these parameters. Methods Fifty-five ACHD underwent transthoracic echocardiographic assessment of RV function, including conventional parameters and longitudinal RV strain, both measured from four RV walls using 2D MPE. The patients also completed a cardiopulmonary exercise test and a QoL questionnaire, and were randomized to either conventional care or a 16-week home-based rehabilitation program combining aerobic interval cycle training and dynamic strength exercises, followed by retesting. Results At baseline, RV function correlated with EC, measured by percent-predicted peak oxygen consumption. Moreover, significant correlations were observed between RV and QoL parameters, including physical functioning, general health perception and visual analogue scale score. EC, muscle strength and QoL improved following the exercise program, while 39% of patients in the intervention group were non-adherent. Conclusion RV function correlates with EC and QoL in a diverse ACHD population. ACHD patients should be encouraged to engage in regular exercise, and exercise training should be integrated into CHD treatment.