Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-29T19:12:59.509Z Has data issue: false hasContentIssue false

Determinants of physical activity in young adults with tetralogy of Fallot

Published online by Cambridge University Press:  20 November 2012

Roselien Buys*
Affiliation:
Department of Rehabilitation Sciences, Research Center for Cardiovascular and Respiratory Rehabilitation, University of Leuven, Tervuursevest, Leuven, Belgium
Werner Budts
Affiliation:
Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium
Christophe Delecluse
Affiliation:
Department of Biomedical Kinesiology, Research Centre for Exercise and Health, University of Leuven, Leuven, Belgium
Luc Vanhees
Affiliation:
Department of Rehabilitation Sciences, Research Center for Cardiovascular and Respiratory Rehabilitation, University of Leuven, Tervuursevest, Leuven, Belgium
*
Correspondence to: R. Buys, PhD, Department of Rehabilitation Sciences, Research Center for Cardiovascular and Respiratory Rehabilitation, University of Leuven, Tervuursevest 101 – bus 1501, B-3001 Heverlee, Belgium. Tel:+32 486388176; Fax: +32 16 329197; E-mail: [email protected]

Abstract

Background

Although sports participation is allowed to most adult patients with corrected tetralogy of Fallot, a reduced exercise tolerance and reduced perceived physical functioning is often present in these patients. We aimed to investigate daily physical activity in adults with tetralogy of Fallot and to investigate the underlying determinants of physical activity in daily life.

Methods

We studied 73 patients with tetralogy of Fallot (53 male; mean age 27.3 ± 7.9 years) who underwent echocardiography and cardiopulmonary exercise testing, and who completed questionnaires about physical activity and perceived health status. All variables were compared with data from a general population. Relationships were studied by Pearson or Spearman correlation coefficients with correction for multiple testing.

Results

Patients were significantly less active compared with the general population (p > 0.05), 55% of all patients were sedentary, 27% had an active or moderately active lifestyle, and 18% of the group had a vigorously active lifestyle. Peak oxygen uptake (71 ± 16%; p < 0.0001) was significantly reduced and related to reduced physical activity levels (r = 0.229; p = 0.017) and perceived physical functioning (r = 0.361; p = 0.002).

Conclusions

Adult patients with tetralogy of Fallot have a sedentary lifestyle and are less active than the general population. Inactivity significantly contributes to reduced exercise capacity, in addition to the impairment based on the cardiac condition. Moreover, reduced exercise capacity and the intensity of sports performed in daily life are related to perceived physical functioning. Individual patient counselling on physical activity might be a low-cost, high-benefit measure to be taken in this patient population.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Moons, P, Sluysmans, T, De Wolf, D, et al. Congenital heart disease in 111,225 births in Belgium: birth prevalence, treatment and survival in the 21st century. Acta Paediatr 2009; 98: 472477.CrossRefGoogle Scholar
2. van der Linde, D, Konings, EE, Slager, MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 2011; 58: 22412247.CrossRefGoogle ScholarPubMed
3. Takken, T, Giardini, A, Reybrouck, T, et al. Recommendations for physical activity, recreation sport, and exercise training in paediatric patients with congenital heart disease: a report from the Exercise, Basic & Translational Research Section of the European Association of Cardiovascular Prevention and Rehabilitation, the European Congenital Heart and Lung Exercise Group, and the Association for European Paediatric Cardiology. 2012. DOI: 10.1177/1741826711420000.CrossRefGoogle Scholar
4. Graham, TP Jr, Bricker, JT, James, FW, Strong, WB. 26th Bethesda conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. Task Force 1: congenital heart disease. J Am Coll Cardiol 1994; 24: 867–873.CrossRefGoogle Scholar
5. Dua, JS, Cooper, AR, Fox, KR, Graham, SA. Physical activity levels in adults with congenital heart disease. Eur J Cardiovasc Prev Rehabil 2007; 14: 287293.CrossRefGoogle ScholarPubMed
6. Muller, J, Hess, J, Hager, A. Daily physical activity in adults with congenital heart disease is positively correlated with exercise capacity but not with quality of life. Clin Res Cardiol 2012; 101: 5561.CrossRefGoogle Scholar
7. Diller, GP, Dimopoulos, K, Okonko, D, et al. Exercise intolerance in adult congenital heart disease: comparative severity, correlates, and prognostic implication. Circulation 2005; 112: 828835.CrossRefGoogle ScholarPubMed
8. Fredriksen, PM, Veldtman, G, Hechter, S, et al. Aerobic capacity in adults with various congenital heart diseases. Am J Cardiol 2001; 87: 310314.CrossRefGoogle ScholarPubMed
9. Buys, R, Cornelissen, V, Van De Bruaene, A, et al. Measures of exercise capacity in adults with congenital heart disease. Int J Cardiol 2011; 153: 2630.CrossRefGoogle ScholarPubMed
10. Hager, A, Hess, J. Comparison of health related quality of life with cardiopulmonary exercise testing in adolescents and adults with congenital heart disease. Heart 2005; 91: 517520.CrossRefGoogle ScholarPubMed
11. Gratz, A, Hess, J, Hager, A. Self-estimated physical functioning poorly predicts actual exercise capacity in adolescents and adults with congenital heart disease. Eur Heart J 2009; 30: 497504.CrossRefGoogle ScholarPubMed
12. Daliento, L, Mapelli, D, Russo, G, et al. Health related quality of life in adults with repaired tetralogy of Fallot: psychosocial and cognitive outcomes. Heart 2005; 91: 213218.CrossRefGoogle ScholarPubMed
13. Wasserman, K, Whipp, BJ. Excercise physiology in health and disease. Am Rev Respir Dis 1975; 112: 219249.Google ScholarPubMed
14. Matton, L, Wijndaele, K, Duvigneaud, N, et al. Reliability and validity of the flemish physical activity computerized questionnaire in adults. Res Q Exerc Sport 2007; 78: 293306.CrossRefGoogle ScholarPubMed
15. Scheers, T, Philippaerts, R, Van Langendonck, L, et al. Lipid profile in men and women with different levels of sports participation and physical activity. Public Health Nutr 2008; 11: 10981106.CrossRefGoogle ScholarPubMed
16. Scheers, T, Philippaerts, R, Lefevre, J. Variability in physical activity patterns as measured by the SenseWear Armband: how many days are needed? Eur J Appl Physiol 2012; 112(5): 16531662.CrossRefGoogle ScholarPubMed
17. Kamphuis, M, Ottenkamp, J, Vliegen, HW, et al. Health related quality of life and health status in adult survivors with previously operated complex congenital heart disease. Heart 2002; 87: 356362.CrossRefGoogle ScholarPubMed
18. Aaronson, NK, Muller, M, Cohen, PD, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 1998; 51: 10551068.CrossRefGoogle ScholarPubMed
19. Benjamini, Y, Drai, D, Elmer, G, Kafkafi, N, Golani, I. Controlling the false discovery rate in behavior genetics research. Behav Brain Res 2001; 125: 279284.CrossRefGoogle ScholarPubMed
20. FAO/WHO/UNU. Human energy requirements. Report of a Joint FAO/WHO/UNU Expert Consultation. FAO Food and Nutrition Technical Report Series No. 1, Rome, 17 October 2001.Google Scholar
21. Lunt, D, Briffa, T, Briffa, NK, Ramsay, J. Physical activity levels of adolescents with congenital heart disease. Aust J Physiother 2003; 49: 4350.CrossRefGoogle ScholarPubMed
22. Reybrouck, T, Mertens, L. Physical performance and physical activity in grown-up congenital heart disease. Eur J Cardiovasc Prev Rehabil 2005; 12: 498502.CrossRefGoogle ScholarPubMed
23. Caplan, R, Allen, PJ. Physical activity recommendations for adolescents with repaired tetralogy of Fallot: review of the literature and guidelines for practitioners. Pediatr Nurs 2011; 37: 191199.Google ScholarPubMed
24. Harrison, JL, Silversides, CK, Oechslin, EN, Kovacs, AH. Healthcare needs of adults with congenital heart disease: study of the patient perspective. J Cardiovasc Nurs 2011; 26: 497503.CrossRefGoogle ScholarPubMed
25. Therrien, J, Fredriksen, P, Walker, M, Granton, J, Reid, GJ, Webb, G. A pilot study of exercise training in adult patients with repaired tetralogy of Fallot. Can J Cardiol 2003; 19: 685689.Google ScholarPubMed
26. Lane, DA, Lip, GY, Millane, TA. Quality of life in adults with congenital heart disease. Heart 2002; 88: 7175.CrossRefGoogle ScholarPubMed
27. Lu, JC, Cotts, TB, Agarwal, PP, Attili, AK, Dorfman, AL. Relation of right ventricular dilation, age of repair, and restrictive right ventricular physiology with patient-reported quality of life in adolescents and adults with repaired tetralogy of Fallot. Am J Cardiol 2010; 106: 17981802.CrossRefGoogle ScholarPubMed
28. Giardini, A, Specchia, S, Tacy, TA, et al. Usefulness of cardiopulmonary exercise to predict long-term prognosis in adults with repaired tetralogy of Fallot. Am J Cardiol 2007; 99: 14621467.CrossRefGoogle ScholarPubMed
29. Booth, FW, Laye, MJ, Roberts, MD. Lifetime sedentary living accelerates some aspects of secondary aging. J Appl Physiol 2011; 111: 14971504.CrossRefGoogle ScholarPubMed