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Canadian Journal of Cardiology

Physical Activity Is Associated With Better Vascular Function in Children and Adolescents With Congenital Heart Disease

Published:December 28, 2019DOI:https://doi.org/10.1016/j.cjca.2019.12.019

      Abstract

      Background

      Aortic stiffness is an important marker of cardiovascular risk and is elevated in children and adolescents with congenital heart disease (CHD) compared with healthy children; however, in children with CHD, little is known about the interaction between aortic stiffness and physical activity—a key determinant of aortic stiffness.

      Methods

      For this cross-sectional cohort study, we recruited children and adolescents aged 9-16 years with moderate-to-complex CHD from British Columbia Children’s Hospital and travelling partnership clinics across the province of British Columbia and the Yukon territory. Mean daily minutes of moderate-to-vigorous physical activity were objectively assessed using an ActiGraph accelerometer worn over the right hip during waking hours for 7 days. Aortic pulse wave velocity (cm/s) was measured using standard 2-dimensional echocardiography and Doppler ultrasound.

      Results

      Participants (n = 104, 61% male; 85% consent rate) had a mean (standard deviation) age of 12.4 (2.4) years. Daily moderate-to-vigorous physical activity was 46.7 (20.0) minutes/d, with 25% meeting guidelines of ≥ 60 minutes of moderate-to-vigorous physical activity per day. Mean (standard deviation) aortic pulse wave velocity was 490.5 (161.9) cm/s, which was not significantly different between cardiac diagnoses. Higher levels of moderate-to-vigorous physical activity were associated with lower aortic pulse wave velocity (r = −0.226, P = 0.021).

      Conclusion

      In children and adolescents with CHD, higher levels of physical activity are associated with better vascular function. Given this association, promoting physical activity should be a high priority in the care of children and adolescents with CHD.

      Résumé

      Contexte

      La rigidité aortique constitue un marqueur important de risque cardiovasculaire et est élevée chez les enfants et les adolescents atteints de cardiopathie congénitale (CC) par rapport aux enfants en bonne santé; toutefois, chez les enfants atteints de CC, on en sait peu au sujet de l’interaction entre la rigidité aortique et l’activité physique – un déterminant clé de la rigidité aortique.

      Méthodologie

      Pour cette étude de cohorte transversale, nous avons recruté des enfants et des adolescents âgés de 9 à 16 ans atteints de CC modérée ou complexe au British Columbia Children’s Hospital et dans les cliniques partenaires itinérantes à l’échelle de la Colombie-Britannique et du Yukon. Le nombre quotidien moyen de minutes d’activité physique modérée ou intense a été évalué objectivement pendant sept jours à l’aide d’un accéléromètre ActiGraph porté sur la hanche droite durant les heures de veille. La vitesse de l’onde de pouls aortique (cm/s) a été mesurée par échocardiographie bidimensionnelle standard et échographie Doppler.

      Résultats

      Les participants (n = 104, 61 % de sexe masculin; taux de consentement de 85 %) étaient âgés de 12,4 ans en moyenne (écart-type : 2,4 ans). Le nombre quotidien de minutes d’activité physique modérée ou intense était de 46,7 (20,0), et 25 % des sujets cumulaient au moins 60 minutes d’activité physique modérée ou intense chaque jour comme le recommandent les lignes directrices. La vitesse moyenne de l’onde de pouls aortique était de 490,5 cm/s (écart-type : 161,9 cm/s) et ne présentait pas de différence interdiagnostique significative sur le plan cardiologique. Un volume plus élevé d’activité physique modérée ou intense se trouvait associé à une moindre vitesse de l’onde de pouls aortique (r = -0,226, p = 0,021).

      Conclusion

      Chez les enfants et les adolescents atteints de CC, un volume d’activité physique plus élevé est associé à une meilleure santé vasculaire. À la lumière de cette constatation, la promotion de l’activité physique devrait être hautement prioritaire dans le cadre des soins aux enfants et aux adolescents atteints de CC.
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