Overweight predicts poorer exercise capacity in congenital heart disease patients

Abstract

BackgroundOverweight (OW) and obesity (OB) are endemic in the United States and affect adolescents and adults with congenital heart disease (ACHD). Defining the burden of excess weight on the cardiovascular system in ACHD is the goal of this study. Limitation of exercise capacity due to overweight or obesity might be reversible with weight loss and improve quality of life for ACHD adults.MethodsExercise tests performed using a Bruce protocol and measurement of maximum oxygen consumption were retrospectively reviewed on 418 CHD patients. OW and OB were defined as the 85–95 or > 95 percentile respectively for age and gender or by adult criteria. Severity of CHD was assigned based on criteria published in standard guidelines.Results63 patients had mild, 198 moderate, and 157 severe heart disease. Each ACHD group was 32 to 34% OW or OB. Measured exercise time (ET) of CHD patients with moderate or severe heart disease was less than that of controls in each weight categories. However, OB or OW people have shorter ET than their normal weight peers with CHD. Multiple regression using ET as the dependent variable finds that female sex, relative BMI, and VE/VCO2 at peak exercise are all associated with lesser ET with high significance. Peak heart rate is associated with greater ET, with borderline significance. Severity of heart disease is not independently associated with ET.ConclusionsOW and OB are strongly associated with reduced ET in persons with congenital heart disease. Losing weight may improve exercise capacity in ACHD.

Obesity in Patient with Grown Up Congenital Heart Disease Ventricular Septal Defect with Pulmonary Hypertension in Sanglah Hospital, Bali, Indonesia

“…Other study concluded obesity did not affect the mortality and short term outcomes with adult population, but there is an increase of renal impairment on obese severe congenital heart disease patient. 20 Patient with congenital heart disease have an increased risk for developing metabolic syndrome, and may be because of several risk factors including exercise restriction and differing nutritional strategies in infancy. 19,20 In our patient, the risk for metabolic syndrome is augmented by his obesity.…”

“…20 Patient with congenital heart disease have an increased risk for developing metabolic syndrome, and may be because of several risk factors including exercise restriction and differing nutritional strategies in infancy. 19,20 In our patient, the risk for metabolic syndrome is augmented by his obesity. Obesity in congenital heart disease have also been seen to have lesser exercise time even with a milder disease severity.…”

The benefits of Shuai Shou Gong (SSG) demonstrated in a Randomised Control Trial (RCT) study of older adults in two communities in Thailand

“…For this reason SSG has frequently been used by researchers interested in studying the benefits of exercise for promoting health in older populations. For example, several studies have been performed to investigate the effect of SSG exercise on the physiology of older adults in community settings [10][11][12][13][14] and also patients with obesity [15], diabetes [16][17][18][19] and heart disease [20]. The particular effect of SSG on cognitive function in older subjects has also been investigated [21][22][23], although it would appear that the protocols used did not always fully and accurately incorporate all the customary elements.…”