Decreased Hand-Grip Strength in Adolescents and Adults with Congenital Heart Disease Depending on Cyanosis

Neidenbach, Rhoia; Müller, Jan; Ewert, Peter; Hager, A.

doi:10.1055/s-0036-1571911

Cited by 1 publication

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“…In our previous research with a similar cohort to this one 34 we presented the finding that handgrip was reduced in the entire CHD group, compared with the controls ( p < 0.001) and decreased with defect severity. The severest reduction was present in patients with cyanosis before treatment, in right-sided cardiac anomalies, in univentricular hearts after Fontan operation, and in currently-cyanotic patients.…”

Section: Discussionmentioning

confidence: 59%

“…These lifestyle changes may include physical activity, which is one of the most cost-effective and beneficial health interventions in healthy people and one which CHD patients often do not receive. They tend to begin with lower aerobic fitness 33 and strength 34 than their peers, and then further avoid activity, 33 especially high-intensity and/or static exercise 15 due to some combination of overprotection and legitimate fear of harm 15,35 by the exercise: 36 Indeed, at least in some forms of CHD (e.g. univentricular heart and Fontan palliation) the pulmonary circulation is supported substantially by ventilation and certain activities, such as the Valsalva maneuver, are contraindicated.…”

Section: Introductionmentioning

confidence: 99%

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Better lung function with increased handgrip strength, as well as maximum oxygen uptake, in congenital heart disease across the lifespan

Smith

Müller

Neidenbach

et al. 2018

Eur J Prev Cardiolog

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Background The respiratory benefits of muscle strength are well-known in heart-healthy populations, but recommendations and research often focus instead on aerobic fitness (peak oxygen uptake) or total activity. Independent benefits of strength thus may be underestimated, especially in congenital heart disease where perceived dangers of certain types of exercise may outweigh perceived benefits. To assess whether it is plausible that pulmonary benefits of strength in heart-healthy populations also apply in congenital heart disease, we simultaneously correlated these patients’ lung function with fitness, strength, and cardiac diagnosis. Methods Lung function (forced expiratory volume in one second percentage predicted (FEV1%pred)) was modeled as function of handgrip strength, congenital heart disease diagnosis, peak oxygen uptake and the interactions of handgrip with sex and diagnosis in 538 Germans (58% male, ages 6–82 years) in linear models corrected for age, sex, height and weight. Congenital heart disease diagnoses were: complex cyanotic; Fallot/Truncus arteriosus communis (common arterial trunk) (TAC); shunts; transposition of the great arteries (TGA); left heart; and other/none. Results Each kg of handgrip was associated with 0.74% higher FEV1%pred ( p < 0.001) and handgrip explained almost 10% of variance in FEV1%pred. While some groups had higher FEV1%pred than others ( p for global null <0.0001), all experienced similar associations with strength ( p for interaction with handgrip >0.10 for both sex and diagnosis.) Correction for peak oxygen uptake eliminated the association with congenital heart disease, but not handgrip. Conclusion Strength was associated with better lung function in all ages even after correction for peak oxygen uptake, regardless of sex and congenital heart disease. This suggests that strength may be at least as important for lung function as aerobic fitness. Heart-safe strength training may improve pulmonary function in congenital heart disease.

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Section: Discussionmentioning

confidence: 59%