DeFaria Yeh D, et al. - In this retrospective study, researchers assessed how impaired right ventricle (RV) exercise reserve affects prognosis in adult patients with congenital heart disease (ACHD). Study participants included 147 ACHD who underwent cardiopulmonary exercise testing with first-pass radionuclide ventriculography at a single tertiary care center. RV reserve was categorized as normal, mild to moderately, or severely impaired. They assessed the occurrence of clinical right heart failure, arrhythmia, transplantation, or death as primary composite clinical outcome. They found that asymptomatic patients had impaired RV reserve, which was not well predicted by resting systolic function assessment, and strongly predicted adverse cardiovascular outcomes.