Griffith, Garett J;  Mayo Clinic, Rochester, MN, USA.
Wang, Alan; Ward, Kendra.

Cardiology in the Young. 36(2):244-251, 2026 Feb.

BACKGROUND: Exercise capacity (VO2peak) predicts mortality in adult
patients with CHD. There is a lack of paediatric exercise capacity data
based on specific CHD lesions, limiting the ability to contextualise
interpretation based on expected performance during testing. The primary
aim of this study was to establish VO2peak percentiles for paediatric
patients with repaired CHD undergoing treadmill-based cardiopulmonary
exercise testing (CPET).

METHODS: Retrospective analysis of CPET data from 2004 to 2022. CPETs
were analysed for patients with CHD aged 6-18 years. Patients with
repaired CHD were categorised based on their most haemodynamically
significant CHD lesion. Percentiles and age-based trends were plotted for
each group.

RESULTS: A total of 887 patients were included. CHD patients were divided
into ten diagnostic subgroups. The mean percent expected VO2peak for each
of the subgroups were as follows: Atrial and ventricular septal defect
(94.5 +/- 25.1%), pulmonary valve repair (88.1 +/- 18.4%), aortic valve
repair (92.7 +/- 16.4%), tricuspid and mitral valve repair (81.3 +/-
20.4%), coarctation of the aorta (93.6 +/- 18.8%), transposition of the
great arteries (90.5 +/- 19.4%), double outlet right ventricle and truncus
arteriosus (80.5 +/- 16.2%), tetralogy of Fallot (85.6 +/- 20.9%), left
ventricle dominant Fontan (74.7 +/- 18.3%), and right ventricle dominant
Fontan (75.7 +/- 16.7%).

CONCLUSION: There is a varying degree of reduced exercise capacity in
paediatric patients with repaired CHD. Univentricular hearts and tricuspid
and mitral valve repair have the lowest VO2peak. These CHD-specific
percentiles may help providers risk-stratify and counsel patients with
CHD.