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Lin S, Gao Q, He X, Zhao Z. Effect of comprehensive nursing methods in postoperative ICU of children with CHD. Cardiol Young 2024; 34:86-91. [PMID: 37226303 DOI: 10.1017/s1047951123000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
To explore effect of comprehensive nursing in postoperative ICU of children with CHD. The subjects were 50 cases of children with CHD treated in our hospital: 25 cases in the control group: routine nursing, and 25 cases in the observation group: comprehensive nursing intervention. The effective rate of 92.00% in the observation group was significantly higher. The serum-free calcium value (1.07 ± 0.11) mmol/L of the observation group on the first day after surgery was significantly lower, and the observation group's creatine phosphate, the daily average dosage of creatine phosphate per unit body weight was significantly higher. 96.00% of patients in the observation group were significantly higher in nursing satisfaction. The complication rate of 8.00% in observation group was significantly lower. In order to successfully complete the operation schedule and improve the postoperative recovery effect of children, high requirements are placed on nursing staff. The comprehensive nursing method used in the postoperative ICU of children with CHD can reduce the incidence of postoperative complications and improve nursing satisfaction.
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Affiliation(s)
- Shaoyan Lin
- Department of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Qiong Gao
- Department of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Xiaoxia He
- Department of Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
| | - Zhirong Zhao
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China
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Inactive Lifestyles among Young Children with Innocent Murmurs or Congenital Heart Disease Regardless of Disease Severity or Treatment. Can J Cardiol 2021; 38:59-67. [PMID: 34555459 DOI: 10.1016/j.cjca.2021.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/18/2021] [Accepted: 09/09/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Sedentary lifestyle morbidities are common among children with congenital heart disease (CHD). Understanding the physical activity trajectory from early childhood could enhance intervention timing/effectiveness. METHODS 154 children (56% male) were recruited at 12-47 months of age for this prospective, longitudinal, observational study. Physical activity and sedentary behaviour (7-day accelerometry) and motor skill (Peabody Developmental Motor Scales-2) were assessed every 8 months until 5 years of age and then annually. Mixed effect repeated measures regression models described outcome trajectories across study assessments. RESULTS Children had an innocent heart murmur (n=28), CHD with insignificant hemodynamics not requiring treatment (n=47), CHD treated by catheterization or surgery without cardiopulmonary bypass (n=31), or CHD treated surgically with bypass (n=48). Motor skill was age appropriate (Peabody 49.0±8.4) but participants had lower physical activity (143±41 mins/day) and higher sedentary time (598±89 mins/day) than healthy peers, starting at 18 months of age. Movement behaviours were not related to treatment group (p>0.10), and physical activity was below the recommended 180 mins/day. Over time, physical activity, sedentary time and motor skill were primarily related to the baseline measure of each outcome (p<0.001). CONCLUSIONS Children with simple or complex CHD or innocent heart murmurs have an increased risk for sedentary lifestyles. Their physical activity and sedentary behaviours are established prior to 2 years of age, persist until school age, and are unrelated to motor skill. These results emphasize the need for interventions targeting the youngest children seen in a cardiac clinic, regardless of CHD diagnosis or innocent murmur.
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Willinger L, Brudy L, Oberhoffer-Fritz R, Ewert P, Müller J. Association between Objectively Measured Physical Activity and Arterial Stiffness in Children with Congenital Heart Disease. J Clin Med 2021; 10:3266. [PMID: 34362050 PMCID: PMC8348234 DOI: 10.3390/jcm10153266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The association between physical activity (PA) and arterial stiffness is particularly important in children with congenital heart disease (CHD) who are at risk for arterial stiffening. The aim of this study was to examine the association between objectively measured PA and arterial stiffness in children and adolescents with CHD. METHODS In 387 children and adolescents with various CHD (12.2 ± 3.3 years; 162 girls) moderate-to-vigorous PA (MVPA) was assessed with the "Garmin vivofit jr." for 7 consecutive days. Arterial stiffness parameters including pulse wave velocity (PWV) and central systolic blood pressure (cSBP) were non-invasively assessed by oscillometric measurement via Mobil-O-Graph®. RESULTS MVPA was not associated with PWV (ß = -0.025, p = 0.446) and cSBP (ß = -0.020, p = 0.552) in children with CHD after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents. Children with CHD were remarkably active with 80% of the study population reaching the WHO recommendation of average 60 min of MVPA per day. Arterial stiffness did not differ between low-active and high-active CHD group after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents (PWV: F = 0.530, p = 0.467; cSBP: F = 0.843, p = 0.359). CONCLUSION In this active cohort, no association between PA and arterial stiffness was found. Longer exposure to the respective risk factors of physical inactivity might be necessary to determine an impact of PA on the vascular system.
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Affiliation(s)
- Laura Willinger
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, 80636 München, Germany; (L.B.); (R.O.-F.); (P.E.); (J.M.)
| | - Leon Brudy
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, 80636 München, Germany; (L.B.); (R.O.-F.); (P.E.); (J.M.)
- Institute of Preventive Pediatrics, Technische Universität München, 80992 München, Germany
| | - Renate Oberhoffer-Fritz
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, 80636 München, Germany; (L.B.); (R.O.-F.); (P.E.); (J.M.)
- Institute of Preventive Pediatrics, Technische Universität München, 80992 München, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, 80636 München, Germany; (L.B.); (R.O.-F.); (P.E.); (J.M.)
| | - Jan Müller
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, 80636 München, Germany; (L.B.); (R.O.-F.); (P.E.); (J.M.)
- Institute of Preventive Pediatrics, Technische Universität München, 80992 München, Germany
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Climie RE, Park C, Avolio A, Mynard JP, Kruger R, Bruno RM. Vascular Ageing in Youth: A Call to Action. Heart Lung Circ 2021; 30:1613-1626. [PMID: 34275753 DOI: 10.1016/j.hlc.2021.06.516] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 12/18/2022]
Abstract
Extensive evidence shows that risk factors for cardiovascular disease (CVD) begin to develop early in life. Childhood obesity and elevated blood pressure (BP) have become overwhelmingly challenging, with 57% of today's children predicted to be obese by the age of 35 years, and global rates of hypertension in children and adolescents increasing by 75% from 2000 to 2015. Thus, there is an urgent need for tools that can assess early CVD risk in youth, which may lead to better risk stratification, preventative intervention, and personalised medicine. Vascular ageing (the deterioration in vascular structure and function) is a pivotal progenitor of health degeneration associated with elevated BP. Exposure to adverse environmental and genetic factors from fetal life promotes the development and accumulation of subclinical vascular changes that direct an individual towards a trajectory of early vascular ageing (EVA)-an independent predictor of target organ damage in the heart, brain, and kidneys. Therefore, characterising vascular ageing from youth may provide a window into cardiovascular risk later in life. However, vascular ageing measurements only have value when techniques are accurate/validated and when reliable thresholds are available for defining normal ranges and ranges that signal increased risk of disease. The aim of this paper is to summarise current evidence on the importance of vascular ageing assessment in youth and the impact of interventions to prevent or delay EVA, to highlight the need for standardisation and validation of measurement techniques in children and adolescents, and the importance of establishing reference values for vascular ageing measures in this population.
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Affiliation(s)
- R E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France.
| | - C Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, UCL, London, UK
| | - A Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - J P Mynard
- Heart Research, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, Vic, Australia
| | - R Kruger
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - R-M Bruno
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France. https://twitter.com/rosam_bruno
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Brudy L, Meyer M, Garcia-Cuenllas L, Oberhoffer R, Hager A, Ewert P, Müller J. Objective Physical Activity Assessment in Clinical Congenital Heart Disease Research: A Systematic Review on Study Quality, Methodology, and Outcomes. Cardiology 2021; 146:240-252. [PMID: 33440380 DOI: 10.1159/000512186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Leon Brudy
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany, .,Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany,
| | - Michael Meyer
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | | | - Renate Oberhoffer
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
| | - Alfred Hager
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Peter Ewert
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Jan Müller
- Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Institute of Preventive Pediatrics, Technische Universität München, Munich, Germany
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Barbour-Tuck E, Boyes NG, Tomczak CR, Lahti DS, Baril CL, Pockett C, Runalls S, Kakadekar A, Pharis S, Bradley TJ, Wright KD, Erlandson MC. A cardiovascular disease risk factor in children with congenital heart disease: unmasking elevated waist circumference - a CHAMPS* study *CHAMPS: Children's Healthy-Heart Activity Monitoring Program in Saskatchewan. BMC Cardiovasc Disord 2020; 20:231. [PMID: 32429858 PMCID: PMC7236104 DOI: 10.1186/s12872-020-01508-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 05/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with congenital heart disease (CHD) have an elevated risk of future cardiovascular disease but the underlying mechanisms are unclear. Abdominal obesity (measured as waist circumference) is a risk factor for adult onset of cardiovascular diseases and is correlated with low physical activity levels, commonly found in children with congenital heart disease. Elevated waist circumference may be a mechanism by which cardiovascular disease risk is elevated in children with CHD. The purpose of this study was to compare waist circumference between children with and without CHD, while considering potential confounders. We hypothesized that children with CHD would have higher measures of waist circumference when controlling for differences in birthweight, lean mass, and physical activity. METHODS Thirty-two children with CHD (10.9 ± 2.6 years; 12 female) from the Children's Healthy-Heart Activity Monitoring Program in Saskatchewan, and 23 healthy controls (11.7 ± 2.5 years; 10 female) were studied. Waist circumference, physical activity (physical activity questionnaire), body composition (lean mass; dual x-ray absorptiometry), and birthweight were assessed. Analysis of covariance, Mann-Whitney U, and independent sample t-tests were used to assess group differences (p < 0.05). RESULTS Children with CHD had greater waist circumference than controls, controlling for lean mass, physical activity, birthweight, and sex (F (1, 49) = 4.488, p = 0.039). Physical activity, lean mass, and birthweight were not significantly different between groups (p > 0.05). CONCLUSION Our findings generate a novel hypothesis-higher waist circumferences in children with CHD compared to age-matched controls, may contribute to an elevated risk of cardiovascular disease.
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Affiliation(s)
- Erin Barbour-Tuck
- Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Natasha G Boyes
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, Saskatchewan, S7N 5B2, Canada
| | - Corey R Tomczak
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, Saskatchewan, S7N 5B2, Canada
| | - Dana S Lahti
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, Saskatchewan, S7N 5B2, Canada
| | - Chantelle L Baril
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, Saskatchewan, S7N 5B2, Canada
| | - Charissa Pockett
- Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Shonah Runalls
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, Saskatchewan, S7N 5B2, Canada
| | - Ashok Kakadekar
- Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Scott Pharis
- Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Timothy J Bradley
- Department of Pediatrics, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Kristi D Wright
- Department of Psychology, University of Regina, Regina, Canada
| | - Marta C Erlandson
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, Saskatchewan, S7N 5B2, Canada.
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Raissadati A, Haukka J, Pätilä T, Nieminen H, Jokinen E. Chronic Disease Burden After Congenital Heart Surgery: A 47-Year Population-Based Study With 99% Follow-Up. J Am Heart Assoc 2020; 9:e015354. [PMID: 32316818 PMCID: PMC7428561 DOI: 10.1161/jaha.119.015354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/25/2020] [Indexed: 01/15/2023]
Abstract
Background Postoperative morbidity is an increasingly important outcome measure of patients who have undergone congenital heart surgery (CHS). We examined late postoperative morbidity after CHS on the basis of patients' government-issued medical special reimbursement rights. Methods and Results Between 1953 and 2009, 10 635 patients underwent CHS at <15 years of age in Finland. We excluded early deaths and mental disabilities. Noncyanotic and cyanotic defects were divided into simple and severe groups, respectively. We obtained 4 age-, sex-, birth time-, and hospital district-matched control subjects per patient. The Social Insurance Institution of Finland provided data on all medical special reimbursement rights granted between 1966 and 2012. Follow-up started at the first operation and ended at death, date of emigration, or December 31, 2012. A total of 8623 patients met inclusion criteria. Follow-up was 99.9%. A total of 3750 patients (43%) required special reimbursements rights for a chronic disease. Cardiovascular disease was the most common late morbidity among patients (28%), followed by obstructive pulmonary disease (9%), neurologic disease (3%), and psychiatric disease (2%). Heart failure (simple hazard ratio [HR], 56.3 [95% CI, 35.4-89.7]; severe HR, 918.0 [95% CI, 228.9-3681.7]) and arrhythmia (simple HR, 11.0 [95% CI, 7.1-17.0]; severe HR, 248.0 [95% CI, 61.3-1002.7]) were the most common cardiovascular morbidities. Hypertension was common among patients with coarctation of the aorta (13%; incidence risk ratio [RR], 8.9; 95% CI, 7.5-10.7). Psychiatric disease was more common among simple defects, particularly ventricular septal defects. Conclusions Chronic cardiac and noncardiac sequelae are common after CHS regardless of the severity of the defect, underscoring the importance of long-term follow-up of all patients after CHS.
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Affiliation(s)
- Alireza Raissadati
- Department of Surgery and CardiologyNew Children’s HospitalUniversity of Helsinki and Helsinki University Central HospitalHelsinkiFinland
- Boston Children’s HospitalBostonMA
| | - Jari Haukka
- Department of Public HealthClinicumFaculty of MedicineUniversity of HelsinkiFinland
- Department of Health SciencesFaculty of Medicine and Health TechnologyUniversity of TampereFinland
| | - Tommi Pätilä
- Department of Surgery and CardiologyNew Children’s HospitalUniversity of Helsinki and Helsinki University Central HospitalHelsinkiFinland
| | - Heta Nieminen
- Department of Surgery and CardiologyNew Children’s HospitalUniversity of Helsinki and Helsinki University Central HospitalHelsinkiFinland
| | - Eero Jokinen
- Department of Surgery and CardiologyNew Children’s HospitalUniversity of Helsinki and Helsinki University Central HospitalHelsinkiFinland
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Hansson L, Lind T, Öhlund I, Wiklund U, Rydberg A. Increased abdominal fat mass and high fat consumption in young school children with congenital heart disease: results from a case‐control study. J Hum Nutr Diet 2020; 33:566-573. [DOI: 10.1111/jhn.12739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- L. Hansson
- Department of Clinical Sciences, Paediatrics Umeå University Umeå Sweden
| | - T. Lind
- Department of Clinical Sciences, Paediatrics Umeå University Umeå Sweden
| | - I. Öhlund
- Department of Clinical Sciences, Paediatrics Umeå University Umeå Sweden
| | - U. Wiklund
- Department of Radiation Sciences Biomedical Engineering Umeå University Umeå Sweden
| | - A. Rydberg
- Department of Clinical Sciences, Paediatrics Umeå University Umeå Sweden
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Physical Activity Is Associated With Better Vascular Function in Children and Adolescents With Congenital Heart Disease. Can J Cardiol 2019; 36:1474-1481. [PMID: 32603699 DOI: 10.1016/j.cjca.2019.12.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/13/2019] [Accepted: 12/22/2019] [Indexed: 12/21/2022] Open
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.
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