Gratz Alexander, Hess John, Hager Alfred
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany.
Eur Heart J. 2009 Feb;30(4):497-504. doi: 10.1093/eurheartj/ehn531. Epub 2008 Dec 9.
The aim of this study is to compare self-reported health-related quality-of-life (HRQoL) with the objective of exercise performance in patients with congenital heart disease (CHD) according to diagnosis.
564 patients (255 females, 14-73 years) with various CHD (62 shunt, 66 left heart obstruction, 33 PS/PR, 47 Ebstein, 96 Fallot, 98 TGA after atrial switch, 38 other TGA, 31 Fontan, 32 palliated/native cyanotic, 61 others) and a group of 53 healthy controls (18 females, 14-57 years) completed a QoL questionnaire (SF-36) and performed a symptom-limited cardiopulmonary exercise test. Despite several limitations at exercise (P = 1.30 x 10(-33)), patients only reported reductions in HRQoL concerning physical functioning (P = 4.41 x 10(-15)) and general health (P = 6.17 x 10(-5)) and not psychosocial aspects. This could be confirmed in all diagnostic subgroups. Correlation to peak oxygen uptake was found in physical functioning (r = 0.435, P = 1.72 x 10(-27)) and general health (r = 0.275, P = 3.79 x 10(-11)). However, there was severe overestimation of physical functioning in most patients when compared with actual exercise test results.
Patients with CHD rate their HRQoL impaired only in physical functioning and general health and not in any psychosocial aspect. Self-estimated physical functioning poorly predicts actual exercise capacity.
本研究旨在根据诊断结果,比较先天性心脏病(CHD)患者自我报告的健康相关生活质量(HRQoL)与运动表现目标。
564例患者(255例女性,年龄14 - 73岁)患有各种先天性心脏病(62例分流、66例左心梗阻、33例肺动脉狭窄/关闭不全、47例埃布斯坦畸形、96例法洛四联症、98例心房调转术后的大动脉转位、38例其他类型的大动脉转位、31例Fontan手术、32例姑息性/原发性青紫型、61例其他类型)以及一组53名健康对照者(18例女性,年龄14 - 57岁)完成了生活质量问卷(SF - 36)并进行了症状限制心肺运动试验。尽管运动时有若干限制(P = 1.30×10⁻³³),但患者仅报告在身体功能(P = 4.41×10⁻¹⁵)和总体健康(P = 6.17×10⁻⁵)方面的HRQoL有所下降,而心理社会方面没有下降。这在所有诊断亚组中都得到了证实。在身体功能(r = 0.435,P = 1.72×10⁻²⁷)和总体健康(r = 0.275,P = 3.79×10⁻¹¹)方面发现与峰值摄氧量相关。然而,与实际运动试验结果相比,大多数患者对身体功能的自我评估严重高估。
先天性心脏病患者仅认为其HRQoL在身体功能和总体健康方面受损,而在任何心理社会方面均未受损。自我估计的身体功能不能很好地预测实际运动能力。