Recommendations for participation in competitive and leisure sports in patients with congenital heart disease: a consensus document

Hirth, Asle; Reybrouck, Tony; Bjarnason-Wehrens, Birna; Lawrenz, Wolfgang; Hoffmann, Andreas

doi:10.1097/01.hjr.0000220574.22195.d6

Cited by 50 publications

(49 citation statements)

References 77 publications

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“…This indicates that, when patients receive optimal medical care, active encouragement to participate in physical activities of moderate intensity will probably result in an improvement of the patient's physical condition. Recent guidelines published by Hirth et al state that d-TGA patients benefit from regular low to moderate intense physical activity, but are not eligible for competitive sport 10 . The current lack of knowledge about the effects and safety of physical activity programmes in this patient group, warrants further research in order to be able to accurately and safely guide the patients towards a more active lifestyle 27 .…”

Section: Univariate Predictorsmentioning

confidence: 99%

“…This reduced peak VO 2 has been related to impaired chronotropic response, impaired systemic ventricular function, impaired function of the intra-atrial conduit, the inability to increase stroke volume, impaired lung function and peripheral deconditioning 1,[4][5][6][7][8] . Moreover, poor exercise capacity identifies d-TGA patients at risk for hospitalization and death 10 .…”

Section: Introductionmentioning

confidence: 99%

“…Recently published guidelines recommend low to moderate dynamic and low static exercise in this patient population 10 . However, most studies do not report on physical activity, although physical activity is well known to improve the aerobic capacity in the general population 10 .…”

Section: Introductionmentioning

confidence: 99%

“…However, most studies do not report on physical activity, although physical activity is well known to improve the aerobic capacity in the general population 10 . Despite a few recent studies, there still is a lack of information on physical activity levels or attitudes towards exercise in this population [11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2012

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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.

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Section: Univariate Predictorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

et al. 2012

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“…So kann der GUCH-Jogger leicht den Ehrgeiz entwickeln, am Greifensee-Lauf eine respektable Zeit zu erreichen und das Prinzip der symptomlimitierten Belastung vernachlässigen. Leitplanken zur Beratung bieten europäische [18] und amerikanische [19] Guidelines. Grundsätzlich gilt, dass bei GUCH-Patienten eine symptomlimitierte kör- …”

Section: Ratschläge Bezüglich Körperlicher Belastung Und Sport Bei Guunclassified

Sport und angeborene Herzfehler beim Erwachsenen

2012

Cardiovasc Med

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Herzgruppen in Deutschland—Status quo und Perspektiven

Bjarnason-Wehrens

Held

Karoff

2006

Herz

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Currently, more than 6,600 heart groups (AHGs) have been established in Germany, in which more than 110,000 patients are physically active. Following cardiac rehabilitation (CR) after an acute event, in the AHG patients aim to meet the set rehabilitation goals in groups of about 15-20 patients, instructed by a competent exercise therapist and attended by a physician. While physical activity has been the dominant aspect thus far, psychosocial and educative elements are now more strongly integrated to stabilize secondary prevention. According to the German rehabilitation law, the patient is legally entitled to participate in AHGs. The insurance companies pay 6.00 Euros for 90 therapeutic units at 60-90 min each. Thereafter, the patient should be encouraged to continue participation at his/her own cost. The opportunity to participate in AHG is not yet sufficiently responded to by the patients. According to different studies, only 13-40% of all patients attend an AHG after phase II CR. In future, special emphasis has to be placed on the recruitment of more patients into AHGs, especially those groups which are known to be underrepresented (e. g., women, old patients, patients with low socioeconomic status). Furthermore, AHGs have to be established for patients with special needs, e. g., heart failure patients or young grown-ups with congenital heart diseases. Until now, the efficiency of AHG participation has not been sufficiently investigated. In a case-control study analyzing the long-term results of AHG participation, an improvement in physical performance as well as a reduction of cardiovascular morbidity (54%) and medical costs (approximately 47%) were observed. In future, more high-class investigations on this field are needed.

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Recommendations for participation in competitive and leisure sports in patients with congenital heart disease: a consensus document

Cited by 50 publications

References 77 publications

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

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

Sport und angeborene Herzfehler beim Erwachsenen

Herzgruppen in Deutschland—Status quo und Perspektiven

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