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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Article info
Publication history
Published online: December 28, 2019
Accepted:
December 22,
2019
Received:
August 18,
2019
Footnotes
See page 1480 for disclosure information.
Identification
Copyright
© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
