Julia Hock1, Barbara Reiner1, Rhoia C Neidenbach2, Renate Oberhoffer1, Alfred Hager2, Peter Ewert2, Jan Müller3. 1. Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany; Institute of Preventive Pediatrics, Technische Universität München, Germany. 2. Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany. 3. Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany; Institute of Preventive Pediatrics, Technische Universität München, Germany. Electronic address: j.mueller@tum.de.
Abstract
OBJECTIVE: Children and adolescents with an univentricular heart after total cavopulmonary connection (TCPC) have functional impairments. This study assesses health-related physical fitness (HRPF) and exercise capacity, as well as their relation to health-related quality of life (HRQoL) in patients with an univentricular heart after total-pulmonary connection (TCPC). PATIENTS AND METHODS: Between July 2014 and October 2016 a total of 78 children and adolescents with TCPC (12.0±3.2years, 21 female) performed a motor test including five tasks for strength and flexibility during their routine follow-up appointment. They also underwent a symptom limited cardio-pulmonary exercise test and filled in a HRQoL questionnaire (KINDL-R). Patients' data were compared to a recent sample of healthy children (n=1650, 12.6±2.4years, 49% female). RESULTS: Multivariable regressions corrected for sex, age and BMI showed that TCPC patients achieved 12.4 repetitions of curl-ups (p<0.001) and 2.6 push-ups (p=0.010) less than healthy counterparts. They had impairments in trunk (-8.5cm; p<0.001), shoulder (-7.5cm; p<0.001) and lower limb flexibility (-4.7cm; p<0.001). Peak oxygen uptake was reduced to 34.8±7.5ml/min/kg and 77.7% respectively, compared to peers (p<0.001). Ventilatory efficiency was also impaired (healthy: 27.5±2.9 vs. TCPC: 31.6±3.3; p<0.001). HRQoL did not differ significantly (p=0.233). CONCLUSIONS: Children and adolescents with TCPC still present impaired HRPF and exercise capacity whereas HRQoL is similar to healthy peers. Since low HRPF may yield to worse motor competence and exercise capacity, early screening for HRPF and early treatment, if indicated, is recommended.
OBJECTIVE:Children and adolescents with an univentricular heart after total cavopulmonary connection (TCPC) have functional impairments. This study assesses health-related physical fitness (HRPF) and exercise capacity, as well as their relation to health-related quality of life (HRQoL) in patients with an univentricular heart after total-pulmonary connection (TCPC). PATIENTS AND METHODS: Between July 2014 and October 2016 a total of 78 children and adolescents with TCPC (12.0±3.2years, 21 female) performed a motor test including five tasks for strength and flexibility during their routine follow-up appointment. They also underwent a symptom limited cardio-pulmonary exercise test and filled in a HRQoL questionnaire (KINDL-R). Patients' data were compared to a recent sample of healthy children (n=1650, 12.6±2.4years, 49% female). RESULTS: Multivariable regressions corrected for sex, age and BMI showed that TCPCpatients achieved 12.4 repetitions of curl-ups (p<0.001) and 2.6 push-ups (p=0.010) less than healthy counterparts. They had impairments in trunk (-8.5cm; p<0.001), shoulder (-7.5cm; p<0.001) and lower limb flexibility (-4.7cm; p<0.001). Peak oxygen uptake was reduced to 34.8±7.5ml/min/kg and 77.7% respectively, compared to peers (p<0.001). Ventilatory efficiency was also impaired (healthy: 27.5±2.9 vs. TCPC: 31.6±3.3; p<0.001). HRQoL did not differ significantly (p=0.233). CONCLUSIONS:Children and adolescents with TCPC still present impaired HRPF and exercise capacity whereas HRQoL is similar to healthy peers. Since low HRPF may yield to worse motor competence and exercise capacity, early screening for HRPF and early treatment, if indicated, is recommended.
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