Cardiopulmonary fitness in children with congenital heart diseases versus healthy children

• Published in: Heart (British Cardiac Society) Vol. 104; no. 12; p. 1026
• Main Authors: Amedro, Pascal, Gavotto, Arthur, Guillaumont, Sophie, Bertet, Helena, Vincenti, Marie, De La Villeon, Gregoire, Bredy, Charlène, Acar, Philippe, Ovaert, Caroline, Picot, Marie-Christine, Matecki, Stefan
• Format: Journal Article
• Language: English
• Published: England 01-06-2018
• Subjects: Adolescent; Age Factors; Cardiorespiratory Fitness; Case-Control Studies; Child; Child, Preschool; Cross-Sectional Studies; Exercise Test; Exercise Tolerance; Female; France; Health Status; Heart Defects, Congenital - diagnosis; Heart Defects, Congenital - physiopathology; Humans; Male; Oxygen Consumption; Predictive Value of Tests; Prognosis; France; congenital heart disease; cardiac rehabilitation
• ISSN: 1468-201X
• DOI: 10.1136/heartjnl-2017-312339

We aimed to compare the cardiopulmonary fitness of children with congenital heart diseases (CHD) with that of age-adjusted and gender-adjusted controls. We also intended to identify clinical characteristics associated with maximum oxygen uptake (VO
) in this population.
We included in a cross-sectional multicentre study a total of 798 children (496 CHD and 302 controls) who underwent a complete cardiopulmonary exercise test (CPET). The association of clinical characteristics with VO
was studied using a multivariate analysis. Mean VO
in the CHD group and control represented 93%±20% and 107%±17% of predicted values, respectively. VO
was significantly lower in the CHD group, overall (37.8±0.3vs 42.6±0.4 mL/kg/min, P<0.0001) and for each group (P<0.05). The mean VO
decline per year was significantly higher in CHD than in the controls overall (-0.84±0.10 vs -0.19±0.14 mL/kg/min/year, P<0.01), for boys (-0.72±0.14vs 0.11±0.19 mL/kg/min/year, P<0.01) and for girls (-1.00±0.13 vs -0.55±0.21 mL/kg/min/year, P=0.05). VO
was associated with body mass index, ventilatory anaerobic threshold, female gender, restrictive ventilatory disorder, right ventricle systolic hypertension, tricuspid regurgitation, the number of cardiac catheter or surgery procedures, and the presence of a genetic anomaly.
Although the magnitude of the difference was not large, VO
among children with CHD was significantly lower than in normal children. We suggest performing CPET in routine follow-up of these patients.
ClinicalTrials.gov NCT01202916;Post-results.