Physical activity modulates arterial stiffness in children with congenital heart disease: A CHAMPS cohort study

Abstract

Low-physically active children with congenital heart disease have increased arterial stiffness compared to high-physically active children with congenital heart disease and healthy-matched controls. Regular physical activity in children with congenital heart disease may modulate arterial stiffness.

A cardiovascular disease risk factor in children with congenital heart disease: unmasking elevated waist circumference - a CHAMPS* study *CHAMPS: Children’s Healthy-Heart Activity Monitoring Program in Saskatchewan

“…Physical activity is known to decrease adiposity and BMI, and markers of stress and chronic inflammation, and to mitigate the association between stress and adiposity in otherwise healthy children [51][52][53][54]. Physical activity has similar health benefits in children with CHD [16,40,[55][56][57]; thus early stress experienced by children with CHD may underlie findings of elevated waist circumference, and weaker associations between physical activity and waist circumference. The theory is compelling that there exists a cascade whereby early physical and psychological stress leads to elevated inflammation and cortisol, which drives elevated abdominal fat accrual, further contributing to inflammation and vascular alteration, which cannot be fully offset by physical activity, and ultimately leading to increased cardiovascular disease risk.…”

“…Clinical relevance: future cardiovascular disease risk for children with CHD Abdominal fat accrual has strong associations with arterial stiffness and cardiovascular disease risk, and predicts left ventricular mass and diastolic function independent of BMI in healthy children and adults [21,[59][60][61]. Increased arterial stiffness [16] and abnormal cardiac function are common in children with various CHD lesions [62], and these disparities compared to healthy controls may worsen with age [63]. As such, children with CHD appear to be at an elevated risk of early-onset chronic cardiovascular diseases like hypertension and coronary artery disease, and metabolic diseases like type 2 diabetes [1].…”

“…Preclinical markers and risk factors of these diseases (e.g., hypertension, dyslipidemia, dysglycemia, arterial stiffness, and low exercise capacity) arise during childhood in association with elevated adiposity and waist circumference, and low physical activity [5][6][7][8][9][10]. The prevalence of low physical activity, overweight, and obesity in children with CHD [11][12][13][14][15] may account for disparities in preclinical markers in childhood and cardiovascular and metabolic diseases in this population later in life [16]. The relationships between physical activity, body fat, and body mass index (BMI) with health are ubiquitous; however, they do not entirely explain the observed differences in preclinical markers or fitness between children with CHD and healthy peers.…”

“…Studies in children with CHD often measure only body fat or identify overweight by BMI, and conclude that there are no differences in fatness between CHD and healthy children contributing to the differences in health markers (i.e., arterial stiffness, fitness, etc.) [14,16], but these observations may be incomplete. Waist circumference is often overlooked in the analyses [25], or the analyses do not account for key potential moderators of waist circumference such as birthweight, sex, body size, and physical activity [16,26].…”

“…[14,16], but these observations may be incomplete. Waist circumference is often overlooked in the analyses [25], or the analyses do not account for key potential moderators of waist circumference such as birthweight, sex, body size, and physical activity [16,26]. The inclusion of waist circumference and its moderators may be critical to understanding the mechanisms behind the high rates of cardiometabolic diseases in this population.…”