Negative Impact of Obesity on Ventricular Size and Function and Exercise Performance in Children and Adolescents With Repaired Tetralogy of Fallot

Aly, Safwat; Santamaria, Ramiro W. Lizano; Devlin, Paul J.; Jegatheeswaran, Anusha; Russell, Jennifer; Seed, Mike; McCrindle, Brian W.

doi:10.1016/j.cjca.2020.06.015

Cited by 8 publications

(4 citation statements)

References 24 publications

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“…It is not just patients with Fontan who suffer complications related to obesity. Pediatric patients with repaired tetralogy of Fallot who were obese had decreased ventricular ejection fractions, increased ventricular size, and impaired exercise fitness as compared with nonobese tetralogy children [24].…”

Section: Self-management/independencementioning

confidence: 95%

Unique clinical challenges for the teenager with congenital heart disease

Pastor,

Elder

2023

Current Opinion in Pediatrics

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Purpose of review On top of existing rites of passage, adolescents with congenital heart disease (CHD) face additional challenges as related to their underlying medical condition. These include compliance with medications and appointments, establishing heart-healthy behaviors, navigating potential at-risk situations, and transition to adult-oriented care. Recent findings Teenagers with CHD should focus on the importance of exercise as this seems to have important long-term benefits and may help improve weight management. Mental health concerns are a major issue for teens with CHD and awareness and appropriate screening are critical. Discussion regarding sexual health, contraception, pregnancy, and CHD risk in offspring occur rarely in clinical practice, and their absence sets up the CHD adolescent for potential complications. Establishing patterns of trust and communication between physicians and teenage CHD patients are critical to enable the appropriate transition of care to adult congenital care, yet gaps in transition remain common. Summary The outpatient cardiologist has a critical role to help the teenager with CHD navigate difficult terrain. Returning to the roots of careful history taking, motivational interviewing, and open-ended questions may be of great benefit in warding off complications and helping steer the adolescent with CHD towards a life as a successful adult living with CHD.

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Section: Self-management/independencementioning

confidence: 95%

Unique clinical challenges for the teenager with congenital heart disease

Pastor,

Elder

2023

Current Opinion in Pediatrics

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“…Obesity poses significant challenges for individuals with Tetralogy of Fallot (TOF), impacting their cardiovascular health and overall well-being. Research has shown that obesity can exacerbate cardiovascular risk factors in TOF patients, leading to increased systemic hypertension and reduced exercise tolerance [74][75][76]. The additional strain on the heart from excess weight is particularly concerning for individuals with pre-existing cardiac abnormalities like TOF.…”

Section: Obesity and Tetralogy Of Fallotmentioning

confidence: 99%

“…Moreover, obesity has been associated with a higher risk of postoperative complications after TOF repair surgery. Obese TOF patients may experience longer hospital stays, higher rates of postoperative complications, and an increased likelihood of requiring mechanical ventilation [74][75][76].…”

Section: Obesity and Tetralogy Of Fallotmentioning

confidence: 99%

Childhood Obesity and Congenital Heart Disease: A Lifelong Struggle

Di Salvo,

Cattapan,

Fumanelli

et al. 2023

JCM

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Congenital heart disease (CHD) affects approximately one in every one hundred infants worldwide, making it one of the most prevalent birth abnormalities globally. Despite advances in medical technology and treatment choices, CHD remains a significant health issue and necessitates specialized care throughout an individual′s life. Childhood obesity has emerged as a novel global epidemic, becoming a major public health issue, particularly in individuals with lifelong conditions such as CHD. Obesity has profound effects on cardiac hemodynamics and morphology, emphasizing the importance of addressing obesity as a significant risk factor for cardiovascular health. Obesity-induced alterations in cardiac function can have significant implications for cardiovascular health and may contribute to the increased risk of heart-related complications in obese individuals. Moreover, while diastolic dysfunction may be less apparent in obese children compared to adults, certain parameters do indicate changes in early left ventricular relaxation, suggesting that obesity can cause cardiac dysfunction even in pediatric populations. As most children with CHD now survive into adulthood, there is also concern about environmental and behavioral health risk factors in this particular patient group. Addressing obesity in individuals with CHD is essential to optimize their cardiovascular health and overall quality of life. This review aims to succinctly present the data on the impact of obesity on CHD and to enhance awareness of this perilous association among patients, families, and healthcare providers.

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“…Lower skeletal muscle mass and higher body fat percentage were associated with late complications or extracardiac organ dysfunction [11 ▪ ]. Aly et al found that obese patients with repaired tetralogy of Fallot had greater right and left ventricular end-diastolic volumes and lower oxygen consumption at peak and anaerobic threshold than repaired tetralogy of Fallot patients with normal BMI [12 ▪ ]. Both authors argue that obesity is an important target to be addressed, potentially with cardiac rehabilitation programs.…”

Section: Introductionmentioning

confidence: 99%

Every child with congenital heart disease should be exercising

Hansen

Tierney

2021

Current Opinion in Cardiology

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Purpose of reviewHistorically, children with congenital heart disease have been restricted from exercise, contributing to a sedentary lifestyle as well as increased cardiovascular risk factors. Given the large benefits and small risks of exercise in this population, guidelines have recently shifted towards exercise promotion. However, these recommendations have yet not gained traction and children with congenital heart disease continue to live sedentary lives. The purpose of this review is to summarize the current literature on exercise and exercise promotion in this population. Recent findingsNew literature reinforces the importance of recommending exercise and improving exercise capacity both in congenital heart disease in general and for specific lesions. Exercise recommendations should be individualized based on functional parameters using a structured methodology to approach the evaluation, risk classification, and prescriptions of exercise and physical activity. SummaryRegular exercise is essential for children with congenital heart disease and providers must take an active role in providing exercise recommendations for their patients. Exercise promotion remains a challenge, necessitating novel approaches to promote exercise. Further studies are needed to improve the risk stratification of patients with congenital heart disease, assess the long-term outcomes of specific exercise interventions, and inform individualized recommendations to encourage children with congenital heart disease to safely engage in exercise and establish healthy lifelong habits that will decrease their cardiovascular risk.

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Negative Impact of Obesity on Ventricular Size and Function and Exercise Performance in Children and Adolescents With Repaired Tetralogy of Fallot

Cited by 8 publications

References 24 publications

Unique clinical challenges for the teenager with congenital heart disease

Unique clinical challenges for the teenager with congenital heart disease

Childhood Obesity and Congenital Heart Disease: A Lifelong Struggle

Every child with congenital heart disease should be exercising

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