Physical activity in adults with congenital heart disease and associations with functional outcomes

Müller, Jan; Amberger, T.; Berg, A.; Goeder, Daniel; Remmele, Julia; Oberhoffer, Renate; Ewert, Peter; Hager, Alfred

doi:10.1136/heartjnl-2016-310828

Cited by 35 publications

(32 citation statements)

References 27 publications

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“…We found that the complexity of CHD was associated with physical activity level. This finding contrasts with previous reports [ 12 , 42 , 44 ]. In two previous studies, a slightly different definition of complexity was applied with two groups of complexity instead of three as used in this present investigation [ 35 ].…”

Section: Discussioncontrasting

confidence: 99%

Geographical variation and predictors of physical activity level in adults with congenital heart disease

Larsson

Johansson

Sandberg

et al. 2019

IJC Heart & Vasculature

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BackgroundPhysical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease (CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents (METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin.Methods3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated whether WHO recommendations were achieved or not. Associated factors were investigated using Generalized Linear Mixed Models.ResultsOn average, 31% reached the WHO recommendations but with a great variation between geographical areas (India: 10%–Norway: 53%). Predictors for physical activity level in line with the WHO recommendations, with country of residence as random effect, were male sex (OR 1.78, 95%CI 1.52–2.08), NYHA-class I (OR 3.10, 95%CI 1.71–5.62) and less complex disease (OR 1.46, 95%CI 1.16–1.83). In contrast, older age (OR 0.97, 95%CI 0.96–0.98), lower educational level (OR 0.41, 95%CI 0.26–0.64) and being unemployed (OR 0.57, 95%CI 0.42–0.77) were negatively associated with reaching WHO recommendations.ConclusionsA significant proportion of patients with CHD did not reach the WHO physical activity recommendations. There was a large variation in physical activity level by country of origin. Based on identified predictors, vulnerable patients may be identified and offered specific behavioral interventions.

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Section: Discussioncontrasting

confidence: 99%

Geographical variation and predictors of physical activity level in adults with congenital heart disease

Larsson

Johansson

Sandberg

et al. 2019

IJC Heart & Vasculature

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“…Being unable to be physically active like others seemed to create a feeling of exclusion with a negative impact on their social life. This is also confirmed in studies where low physical activity level and inactivity is related to impaired mental and physical health‐related quality of life (Muller et al., ). Their wish to be like others is in agreement with earlier research where the struggle for normality is described as an ongoing dynamic process, which varies throughout the lifespan (Claessens et al., ; Overgaard et al., ).…”

Section: Discussionsupporting

confidence: 52%

It’s like balancing on a slackline—A description of how adults with congenital heart disease describe themselves in relation to physical activity

Bay

Lämås

Berghammer

et al. 2018

Journal of Clinical Nursing

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“…1 Due to progress made in the fields of early diagnostics, surgical techniques, and follow-up, the percentage of patients reaching adulthood has constantly risen over the last few decades and is now over 90%. [2][3][4] With higher life expectancy, new aims develop that go far beyond reaching adulthood and move focus on lifestyle and quality of life. One key aspect contributing to the improvement of quality of life in these patients is their physical well-being and fitness.…”

mentioning

confidence: 99%

Mismatch between self-estimated and objectively assessed exercise capacity in patients with congenital heart disease varies in regard to complexity of cardiac defects

et al. 2020

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Aim: Regular evaluation of physical capacity takes a crucial part in long-term follow-up in patients with congenital heart disease (CHD). This study aims to examine the accuracy of self-estimated exercise capacity compared to objective assessments by cardiopulmonary exercise testing in patients with CHD of various complexity. Methods: We conducted a single centre, cross-sectional study with retrospective analysis on 382 patients aged 8–68 years with various CHD who completed cardiopulmonary exercise tests. Peak oxygen uptake was measured. Additionally, questionnaires covering self-estimation of exercise capacity were completed. Peak oxygen uptake was compared to patient’s self-estimated exercise capacity with focus on differences between complex and non-complex defects. Results: Peak oxygen uptake was 25.5 ± 7.9 ml/minute/kg, corresponding to 75.1 ± 18.8% of age- and sex-specific reference values. Higher values of peak oxygen uptake were seen in patients with higher subjective rating of exercise capacity. However, oxygen uptake in patients rating their exercise capacity as good (mean oxygen uptake 78.5 ± 1.6%) or very good (mean oxygen uptake 84.8 ± 4.8%) was on average still reduced compared to normal. In patients with non-complex cardiac defects, we saw a significant correlation between peak oxygen uptake and self-estimated exercise capacity (spearman-rho −0.30, p < 0.001), whereas in patients with complex cardiac defects, no correlation was found (spearman-rho −0.11, p < 0.255). Conclusion: The mismatch between self-estimated and objectively assessed exercise capacity is most prominent in patients with complex CHD. Registration number at Charité Universitätsmedizin Berlin Ethics Committee: EA2/106/14.

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Physical activity in adults with congenital heart disease and associations with functional outcomes

Cited by 35 publications

References 27 publications

Geographical variation and predictors of physical activity level in adults with congenital heart disease

Geographical variation and predictors of physical activity level in adults with congenital heart disease

It’s like balancing on a slackline—A description of how adults with congenital heart disease describe themselves in relation to physical activity

Mismatch between self-estimated and objectively assessed exercise capacity in patients with congenital heart disease varies in regard to complexity of cardiac defects

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