Physical activity is associated with improved aerobic exercise capacity over time in adults with congenital heart disease

Abstract

Background Impaired exercise capacity is common in adults with congenital heart disease (ACHD). This impairment is progressive and is associated with increased morbidity and mortality. We studied the influence of the frequency of at least moderately strenuous physical activity (PhysAct) on changes in exercise capacity of ACHD patients over time. Methods We studied ACHD patients ≥21 years old who had repeated maximal (RER≥1.09) cardiopulmonary exercise tests within 6 to 24 months. On the basis of data extracted from each patient’s clinical records, PhysAct frequency was classified as (1) Low: minimal PhysAct, (2) Occasional: moderate PhysAct <2 times/week, or (3) Frequent: moderate PhysAct ≥2 times/week. Results PhysAct frequency could be classified for 146 patients. Those who participated in frequent exercise tended to have improved pVO2 (ΔpVO2=+1.63±2.67 ml/kg/min) compared to those who had low or occasional activity frequency (ΔpVO2=+0.06±2.13 ml/kg/min, p=0.003) over a median follow-up of 13.2 months. This difference was independent of baseline clinical characteristics, time between tests, medication changes, or weight change. Those who engaged in frequent PhysAct were more likely to have an increase of pVO2 of ≥1SD between tests as compared with sedentary patients (multivariable OR=7.4, 95%CI 1.5-35.7). Aerobic exercise capacity also increased for patients who increased activity frequency from baseline to follow-up; 27.3% of those who increased their frequency of moderately strenuous physical activity had a clinically significant (at least +1SD) increase in pVO2 compared to only 11% of those who maintained or decreased activity frequency. Conclusions ACHD patients who engage in frequent physical activity tend to have improved exercise capacity over time.

Long-term benefits of exercise training in patients with a systemic right ventricle

“…They found no change in right ventricular function, which could be due to small patient numbers, and short follow-up [12]. In 146 patients with congenital heart disease, Tikkanen et al, found improved V'O 2peak in patients involved in regular exercise, as compared to those with a more sedentary lifestyle [13]. Unfortunately, long-term effects of exercise could not be derived from these studies.…”

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

“…While several studies have explored late neurodevelopmental outcomes2, 3, 4, 5 and exercise training on older patients with CHD after surgery,10, 11, 12, 13, 14, 15 little has been published on the acute impact on functional status following CHD surgery, and the associated RT use in the immediate postoperative period.…”

Almanac 2014: congenital heart disease

“…58 Also, patients with ACHD who are physically more active, tend to perform better on exercise testing. 59 Twenty-four weeks of structured aerobic exercise training of adult patients with TGA significantly improves cardiopulmonary exercise testing parameters and reduces HF symptoms without a negative impact on the systemic RV. 60 The benefits of a structured exercise programme combined with psychological training for improving overall activity in adolescents with CHD has also recently been demonstrated.…”