Search

Objective: This study compared objectively measured and self-reported physical activity (PA) in adults with congenital heart disease (ACHD) to a healthy reference cohort (RC). Patients and Methods: From May 2017 to August 2020, 211 ACHD (39.9 ± 9.7 years, 101 female) and 141 healthy adults (35.9 ± 14.7 years, 76 female) participated in a wearable-based and self-reported PA assessment. Moderate-to-vigorous PA (MVPA) and the step count were recorded with the Garmin vivofit® 3 device for 7 consecutive days. Additionally, subjects were asked to report the number of days they are active for ≥30 min throughout the week. Results: Only 33 (17%) ACHD and 36 (26%) healthy controls (p = 0.030) accumulated the World Health Organization's (WHO) recommendation of 150 min MVPA per week. ACHD were less active per week (ACHD: 40.0 [0.0; 101.0] min. MVPA vs. RC: 75.0 [22.5; 152.5] min. MVPA, p = 0.002) and walked fewer daily steps (ACHD: 8,246 [6,505; 10,434] vs. RC: 9,413 [7,621; 11,654], p = 0.001) than healthy controls. Especially, patients with moderate (p = 0.030), complex (p < 0.001), or surgically corrected (p = 0.008) congenital heart disease accumulated significantly less MVPA than healthy peers throughout the week. A large majority of 72% of ACHD and 58% of the RC overestimated their weekly active days by more than one day. Conclusions: ACHD walked quite a few steps daily but lacked intensity. ACHD was less active than healthy controls and failed to reach international recommendations. They therefore need encouragement toward more intense movement to improve the exercise capacity and lower cardiovascular risk. Self-reported PA showed no agreement to the objectively measured PA. [ABSTRACT FROM AUTHOR]

Background: The shift toward a preventative approach in medical aftercare of congenital heart disease (CHD) patients has led to encouragement of regular physical activity (PA) in this patient population. Objective measures are crucial in accurately displaying PA levels and have increasingly found their way into clinical research. This review aims to give an overview about quality, methodology, and outcomes of current scientific work on accelerometers objectively assessing PA in patients with CHD. Methods: Systematically researched literature in all relevant databases (PubMed, Cochrane, and Scopus) over the past decade (2009–2019) with history of CHD and accelerometer-based PA assessment was evaluated by 2 independent reviewers according to the Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung, and Blood Institute. Results: Eight articles with 664 pediatric patients with CHD aged 3–18 years (range 10–162 patients), 5 studies with 574 adults with CHD aged 18–63 years (range 28–330 patients), and 3 studies with 177 pediatric patients and adults with CHD aged 8–52 years were included. Two studies were rated "good"; 9, "fair"; and 5, "poor." Methodologies and devices differed substantially across all studies. Conclusions: Overall study quality was fair at best, and due to difficult methodological comparability of the studies, no clear answer on how active patients with CHD really are can currently be given. Larger studies carefully considering collection and processing criteria, and correct reporting standards exploring PA in patients with CHD from different angles are needed. [ABSTRACT FROM AUTHOR]

Study Design: This is a retrospective cross-sectional study to analyze mortality and the rate of restenosis in the follow-up of patients after surgical repair of isolated aortic coarctation in infancy. Patients and Methods: From 1974 to 2003, 191 patients underwent surgical repair of aortic coarctation in infancy. Follow-up data of 2,432 patient-years were extracted from the clinical files of our outpatient department or from family practitioners. Results: Five patients died (total mortality 2.6%): 1 patient intraoperatively and 2 within 30 days after surgery (early mortality 1.6%). The other 2 patients died within 3 months. All deaths were contributed to patients that underwent surgery in the years up to 1981 and within the first 43 days of life. Of the surviving 186 patients, 31 had reintervention because of restenosis and another 11 patients had a noninvasive brachial-ankle systolic blood pressure gradient >20 mm Hg, suggesting current restenosis. Risk factors for death or restenosis were a hypoplastic aortic arch and a low body length at surgery. Conclusions: Nowadays, surgical repair of coarctation can be performed in infancy with minimal risk. The restenosis rate is considerably high (23%). It is mainly caused by the size of the whole aortic arch, but can also develop during later follow-up. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]