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.
Highlights
Children with congenital heart disease (CHD) are at high cardiovascular risk as a consequence of their congenital condition
The association between physical activity (PA), in the form of moderate-to-vigorous PA (MVPA) and step count, and surrogates of arterial stiffness was analyzed using multivariate linear regression analyses adjusted for age, sex, zscore of the body mass index (BMI), peripheral systolic blood pressure heart rate and intake of hypertensive agents as in our previous analysis on this topic [22,23]
General linear models adjusted for age, sex, z-score BMI, peripheral systolic blood pressure (pSBP), heart rate and intake of hypertensive agents were calculated to detect differences between the high-active and low-active CHD group in pulse wave velocity (PWV) and central systolic blood pressure (cSBP)
Summary
Children with congenital heart disease (CHD) are at high cardiovascular risk as a consequence of their congenital condition. Measures of arterial stiffness were shown to be increased already in children with CHD, predisposing this patient cohort to premature heart failure [6,7]. Physical activity (PA) is a clinically important modifiable risk factor for preventing arterial stiffening of the vessels and for determining risk of cardiovascular disease in children with CHD. Another study reported of an inverse association between high levels of MVPA and lower aortic PWV in children with CHD [21]. This association is important in the way of preventing cardiovascular disease in this patient cohort who showed reduced elasticity of the vascular system already in childhood [6,7].
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