In adults with atrial switch operation for transposition of the great arteries low physical activity relates to reduced exercise capacity and decreased perceived physical functioning

Abstract

Objective Patients with Mustard/Senning repair for transposition of the great arteries (d-TGA) have an impaired exercise capacity, but information about physical activity levels is scarce. The aim of the study was to come to a better understanding of the interrelationships between determinants of exercise capacity, physical activity and self-perceived health status. Methods and resultsWe studied 39 d-TGA patients who underwent echocardiography and exercise testing, and who completed questionnaires about physical activity and perceived health status. All results were compared with normal values. Stepwise multiple regression analysis was used to assess the determinants of peak VO 2 % and exercise duration. Peak VO 2 averaged 64 ± 14.1% of the predicted normal values, which is signifi cantly lower than expected (P < 0.0001). Physical activity measures as well as perceived general health were signifi cantly lower compared to a reference population (P < 0.05). Peak heart rate and peak oxygen pulse explained together 90% of the variability in exercise duration (model F = 162.72; P < 0.0001). Type of surgery, total energy expenditure and right ventricular contractility were independent predictors of peak VO 2 % explaining 43% of the variability (model F = 8.75; P = 0.0002).Conclusions Impaired peak exercise performance in d-TGA patients results mainly from the inability to increase stroke volume and heart rate at higher exercise intensities. Senning repair and a well-preserved right ventricular function are related to a better peak VO 2 %. Furthermore, an active lifestyle has a positive eff ect on exercise capacity and perceived physical functioning. Therefore it might be indicated to encourage d-TGA patients to adopt a more physically active lifestyle.

Sports Participation and Quality of Life in Adolescents and Young Adults with Congenital Heart Disease

“…The associations between physical activity, exercise capacity, and QoL have been previously investigated and summarized in a recent systematic review. 31 Our findings are similar to those of Buys et al, 32 Ubeda Tikkanen et al, 33 and Muller et al 34 who showed that increased physical activity correlates with improved exercise capacity in patients with CHD. Also similar to our study, Buys et al 32 showed that increased physical activity is associated with significantly improved QoL.…”

“…31 Our findings are similar to those of Buys et al, 32 Ubeda Tikkanen et al, 33 and Muller et al 34 who showed that increased physical activity correlates with improved exercise capacity in patients with CHD. Also similar to our study, Buys et al 32 showed that increased physical activity is associated with significantly improved QoL. In contrast, Muller et al 34 and McCrindle, et al 35 found no association between increased physical activity and improved QoL.…”

Serial exercise testing in children, adolescents and young adults with Senning repair for transposition of the great arteries

“…If patients with d-TGA have a low physical activity level during childhood and adolescence, this might counteract with the normal development of their exercise capacity and therefore explain the inability to increase the exercise capacity during growth to the same extent as healthy peers [13]. Moreover, it has recently been shown that adults with atrial switch repair for d-TGA show a reduced physical activity level in comparison with healthy counterparts, which is related to a lower exercise capacity [14]. Even though our data do not show a faster decline of the exercise capacity in young adults, we believe that on the longer term this sedentary lifestyle will probably contribute to the evolution of the exercise intolerance, making it decline faster than in a healthy and generally more active population.…”

Factors Influencing Adaptation and Performance at Physical Exercise in Complex Congenital Heart Diseases after Surgical Repair

“…Furthermore, an active lifestyle has a positive effect on exercise capacity and perceived physical functioning. Therefore it might be indicated to encourage D-TGV patients to adopt a more physically active lifestyle [21]. …”