Increased arterial stiffness in children with congenital heart disease

Häcker, Anna-Luisa; Reiner, Barbara; Oberhoffer, Renate; Hager, Alfred; Ewert, Peter; Müller, Jan

doi:10.1177/2047487317737174

Cited by 26 publications

(26 citation statements)

References 43 publications

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“…Based on the mean value of 0.01794 of the reference cohort, a t-test against 0.01794 was calculated for children with anatomically repaired TGA. General linear models were conducted for central systolic blood pressure and pulse wave velocity adjusting for age, sex, body mass index (BMI), peripheral mean arterial pressure, medication and heart rate to detect differences between TGA and the reference cohort as previously described 18. For differences in HRQoL, a general linear model was performed adjusting for age, sex and BMI.…”

Section: Methodsmentioning

confidence: 99%

Functional outcomes in children with anatomically repaired transposition of the great arteries with regard to congenital ventricular septal defect and coronary pattern

Häcker¹,

Reiner²,

Oberhoffer

et al. 2019

Arch Dis Child

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ObjectiveDespite decreasing mortality, functional impairments in children with transposition of the great arteries (TGA) are still a concern. This study analyses health-related physical fitness (HRPF), arterial stiffness and health-related quality of life (HRQoL) in children with anatomically repaired TGA regarding congenital ventricular septal defect (VSD) and coronary patterns.Patients and methods68 children with anatomically repaired TGA with or without VSD (12.9±3.7 years, 19.1% female) were investigated between August 2014 and October 2017. HRPF was assessed by five tests of the FITNESSGRAM, arterial stiffness was measured by oscillometric measurement using Mobil-O-Graph and HRQoL was analysed with a self-report questionnaire (KINDL-R). All test results were compared with a healthy reference cohort (n=2116, 49.1% female) adjusted for sex and age.ResultsChildren with anatomically repaired TGA had significantly worse HRPF (z-score: −0.58±0.81, p<0.001), increased pulse wave velocity (TGA: 4.9±0.3 m/s vs healthy: 4.8±0.3 m/s, p=0.028) and central systolic blood pressure (TGA: 105.9±5.8 mm Hg vs healthy: 103.3±5.7 mm Hg, p=0.001). No difference was found for HRQoL between the two groups (total HRQoL score: TGA: 76.5±10.2 vs healthy: 75.2±10.1, p=0.315). Neither the coronary pattern nor a congenital VSD resulted in significant differences in all functional outcomes.ConclusionChildren with anatomically repaired TGA exhibit impaired HRPF and increased arterial stiffness whereas their HRQoL is normal. The underlying coronary pattern seems to have no influence on the functional outcome, nor does an accompanied congenital VSD.

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Section: Methodsmentioning

confidence: 99%

Functional outcomes in children with anatomically repaired transposition of the great arteries with regard to congenital ventricular septal defect and coronary pattern

Häcker¹,

Reiner²,

Oberhoffer

et al. 2019

Arch Dis Child

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“…The inbuilt ARCSolver algorithm of the device uses a transfer function to calculate PWV and central systolic blood pressure based on the peripheral wave form (29). The device has shown good validity and applicability in several studies, even in patients with CHD (12, 30, 31). …”

Section: Methodsmentioning

confidence: 99%

“…According to our preceding cross-sectional study (12, 13, 40) a HRPF z-score of about −0.64 ± 0.9 (27th percentile) was averaged in the CHD children in comparison to the healthy reference. The study aims to improve HRPF to a value of 0.0 ± 1.0 (50th percentile) at the end of the intervention.…”

Section: Methodsmentioning

confidence: 99%

“…These skill-based limitations from early infancy are tracked into adulthood with further negative effect on health-related physical fitness (HRPF) and muscle strength (8–11). That those limitations still exist in the vast majority of children with CHD outline recent projects on health-related physical fitness (HRPF) and cardiovascular health (12–17). …”

Section: Introductionmentioning

confidence: 99%

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Web-Based Motor Intervention to Increase Health-Related Physical Fitness in Children With Congenital Heart Disease: A Study Protocol

et al. 2018

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Objective: Exercise interventions are underutilized in children with congenital heart disease (CHD) especially when the primary outcome is not peak oxygen uptake. Most of the studies are restricted to a low sample size and proximity of the patients to the study centers. Now eHealth approaches bear a promising but also challenging opportunity to transmit such intervention programs to participants, and check progress and compliance from remote. This study will aim to improve health-related physical fitness (HRPF) with a 24 weeks web-based exercise intervention.Methods and Design: The current study is planned as a randomized control trial (RCT) with a crossover design and the aim to improve functional outcome measures. It also estimates adherence and feasibility in patients with CHD in this web-based exercise/motor intervention over 24 weeks. Primary outcome will be the improvement of HRPF. Secondary outcomes are, functional and structural arterial stiffness measures and health-related quality of life. Thus, 70 children from 10 to 18 years with CHD of moderate and complex severity will be recruited and allocated randomly 1:1 in two study arms after baseline testing for their HRPF, arterial stiffness measures and health-related quality of life. For 24 weeks, participants in the intervention arm will receive three weekly exercise video clips of 20 min each. Every video clip comprises 20 child-oriented exercises which have to be executed for 30 s followed by a recovery period of 30 s. Each session will start with 3–4 warming-up exercises, followed by 10–12 strength and flexibility exercises, and ending with 3–4 min of cool down or stretching tasks. Continuous video clips will be streamed from a web-based e-Learning platform. The participant simply has to imitate the execution and follow some short advices. After each session, a brief online survey will be conducted to assess perceived exertion and feasibility.Discussion: The study will help to determine the efficacy and applicability of a web-based exercise intervention in children with CHD in regard to functional outcome measures. In addition, it will outline the effectiveness of remote monitoring, which provides a cost effective approach to reach patients with CHD that are low in prevalence and often do not live in close proximity to their tertiary center.Trial Registration: https://ClinicalTrials.gov Identifier: NCT03488797.

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“…Researchers from the Technical University of Munich have shown higher arterial stiffness by analysing central systolic pressure in children with CHD compared with the control group. 21 Thus early detection of arterial dysfunction in children with CHD, but also in children in the general population, may provide a window for early treatment or lifestyle modifications to prevent cardiovascular disease. It is time to move on to a more comprehensive evaluation and management of paediatric cardiometabolic risk factors, such as hypertension and obesity, to optimize prevention of later cardiovascular disease.…”

Section: Arterial Stiffness In Childhoodmentioning

confidence: 99%

Editor’s Presentation

Piepoli

2017

Eur J Prev Cardiolog

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Consistent data on the benefit of interval training in heart failure are available. 1 Guidelines require a period of stability before implementing it in clinical practice. 2 Controversies exist on the timing of starting and its safety and feasibility. In the present issue, interval exercise training started as early as nine days after an episode of heart failure decompensation was safe and effective in improving exercise tolerance and quality of life in selected systolic heart failure patients. 3 Positive effects were sustained after three months. Cardiopulmonary exercise testing was safely performed after careful selection in 19.6% of the study patients. Oscillatory ventilation on exercise, an ominous sign in heart failure, was not detected in the study, although there is evidence that it may be reduced by exercise training.

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Increased arterial stiffness in children with congenital heart disease

Cited by 26 publications

References 43 publications

Functional outcomes in children with anatomically repaired transposition of the great arteries with regard to congenital ventricular septal defect and coronary pattern

Functional outcomes in children with anatomically repaired transposition of the great arteries with regard to congenital ventricular septal defect and coronary pattern

Web-Based Motor Intervention to Increase Health-Related Physical Fitness in Children With Congenital Heart Disease: A Study Protocol

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