Jong Mi Ko1, Kamila S White2, Adrienne H Kovacs3, Kristen M Tecson4, Silke Apers5, Koen Luyckx6, Corina Thomet7, Werner Budts8, Junko Enomoto9, Maayke A Sluman10, Jou-Kou Wang11, Jamie L Jackson12, Paul Khairy13, Stephen C Cook14, Shanthi Chidambarathanu15, Luis Alday16, Katrine Eriksen17, Mikael Dellborg18, Malin Berghammer19, Bengt Johansson20, Andrew S Mackie21, Samuel Menahem22, Maryanne Caruana23, Gruschen Veldtman24, Alexandra Soufi25, Susan M Fernandes26, Edward Callus27, Shelby Kutty28, Philip Moons29, Ari M Cedars30. 1. Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA. 2. Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, University of Missouri, Saint Louis, MO, USA. 3. Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA. 4. Baylor Heart and Vascular Institute, Dallas, TX, USA. 5. KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium. 6. School Psychology and Child and Adolescent Development, KU Leuven - University of Leuven, Leuven, Belgium. 7. Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 8. Division of Congenital and Structural Cardiology, University Hospitals Leuven, Leuven, Belgium; KU Leuven Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium. 9. Department of Adult Congenital Heart Disease,Cardiovascular Center, Chiba, Chiba, Japan. 10. Department of Cardiology,Academic Medical Center, Amsterdam, The Netherlands. 11. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. 12. Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, USA. 13. Adult Congenital Heart Center, Montreal Heart Institute, Université de Montréal, Montreal, Canada. 14. Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, MI, USA. 15. Pediatric Cardiology, Frontier Lifeline Hospital (Dr. K. M. Cherian Heart Foundation), Chennai, India. 16. Division of Cardiology, Hospital de Niños, Córdoba, Argentina. 17. Department of Cardiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway. 18. Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden. 19. Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden; Department of Health Sciences, University West, Trollhättan, Sweden. 20. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 21. Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Canada. 22. Monash Heart, Monash Medical Centre, Monash University, Melbourne, Australia. 23. Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta. 24. Adult Congenital Heart Disease Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 25. Department of Congenital Heart Disease, Louis Pradel Hospital, Hospices civils de Lyon, Lyon, France. 26. Department of Pediatrics and Medicine, Divisions of Pediatric Cardiology and Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. 27. Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy. 28. Adult Congenital Heart Disease Center, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, USA. 29. KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden; Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. 30. Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address: Ari.cedars@utsouthwestern.edu.
Abstract
OBJECTIVE: This study aimed to examine the association between physical activity (PA) and depression in a large international cohort of adults with congenital heart disease (ACHD) as data about the differential impact of PA type on depression in this population are lacking. METHODS: In 2018, we conducted a cross-sectional assessment of 3908 ACHD recruited from 24 ACHD-specialized centers in 15 countries between April 2013 to March 2015. The Hospital Anxiety and Depression Scale was used to assess self-reported depressive symptoms and the Health-Behavior Scale-Congenital Heart Disease was used to collect PA information. Cochran-Armitage tests were performed to assess trends between depressive symptom levels and PA participation. Chi-Square and Wilcoxon Rank Sum tests were utilized to examine relations between depressive symptom levels and patient characteristics. Stepwise multivariable models were then constructed to understand the independent impact of PA on depressive symptoms. RESULTS: The overall prevalence of elevated depressive symptoms in this sample was 12% with significant differences in rates between countries (p < .001). Physically active individuals were less likely to be depressed than those who were sedentary. Of the 2 PA domains examined, sport participation rather than active commute was significantly associated with reduced symptoms of depression. After adjustment in multivariable analysis, sport participation was still significantly associated with 38% decreased probability of depressive symptoms (p < .001). CONCLUSIONS: Sport participation is independently associated with reduced depressive symptoms. The development and promotion of sport-related exercise prescriptions uniquely designed for ACHD may improve depression status in this unique population.
OBJECTIVE: This study aimed to examine the association between physical activity (PA) and depression in a large international cohort of adults with congenital heart disease (ACHD) as data about the differential impact of PA type on depression in this population are lacking. METHODS: In 2018, we conducted a cross-sectional assessment of 3908 ACHD recruited from 24 ACHD-specialized centers in 15 countries between April 2013 to March 2015. The Hospital Anxiety and Depression Scale was used to assess self-reported depressive symptoms and the Health-Behavior Scale-Congenital Heart Disease was used to collect PA information. Cochran-Armitage tests were performed to assess trends between depressive symptom levels and PA participation. Chi-Square and Wilcoxon Rank Sum tests were utilized to examine relations between depressive symptom levels and patient characteristics. Stepwise multivariable models were then constructed to understand the independent impact of PA on depressive symptoms. RESULTS: The overall prevalence of elevated depressive symptoms in this sample was 12% with significant differences in rates between countries (p < .001). Physically active individuals were less likely to be depressed than those who were sedentary. Of the 2 PA domains examined, sport participation rather than active commute was significantly associated with reduced symptoms of depression. After adjustment in multivariable analysis, sport participation was still significantly associated with 38% decreased probability of depressive symptoms (p < .001). CONCLUSIONS: Sport participation is independently associated with reduced depressive symptoms. The development and promotion of sport-related exercise prescriptions uniquely designed for ACHD may improve depression status in this unique population.
Authors: Chun-Wei Lu; Jou-Kou Wang; Hsiao-Ling Yang; Adrienne H Kovacs; Koen Luyckx; Francisco Javier Ruperti-Repilado; Alexander Van De Bruaene; Junko Enomoto; Maayke A Sluman; Jamie L Jackson; Paul Khairy; Stephen C Cook; Shanthi Chidambarathanu; Luis Alday; Erwin Oechslin; Katrine Eriksen; Mikael Dellborg; Malin Berghammer; Bengt Johansson; Andrew S Mackie; Samuel Menahem; Maryanne Caruana; Gruschen Veldtman; Alexandra Soufi; Susan M Fernandes; Kamila White; Edward Callus; Shelby Kutty; Silke Apers; Philip Moons Journal: J Am Heart Assoc Date: 2022-04-26 Impact factor: 6.106