Pasquali Sara K, Marino Bradley S, Pudusseri Anita, Wernovsky Gil, Paridon Stephen M, Walker Susan A, Cohen Meryl S
The Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Am Heart J. 2009 Sep;158(3):473-9. doi: 10.1016/j.ahj.2009.06.019. Epub 2009 Jul 23.
Over 25% of patients with congenital heart disease are obese (OB) or overweight (OW). Unique factors such as activity restriction and early feeding practices may play a role. We evaluated a high-risk cohort predisposed to early coronary artery disease due to past surgery involving coronary artery reimplantation.
Patients at our institution who underwent the arterial switch or Ross operation were included. Data collection included chart review and activity and diet questionnaires. The proportion of OB/OW (body mass index > or =85%) was compared to national data. Factors associated with OB/OW were evaluated.
A total of 106 patients were enrolled. Median age was 14.2 years (6.0-19.9 years); 69% were male. Similar to national data, 31% were OB/OW (vs 31%, P = nonsignificant [NS]). There was no difference comparing OB/OW to normal-weight patients in activity restriction (cardiologist documented 27% vs 27%; parent reported 38% vs 42%, P = NS), activity level (9.8 hours/week [1.7-41.2] vs 11.5 [0.8-52.3], P = NS), or early feeding practices (formula vs breastfeeding, caloric fortification, tube feeding). OB/OW patients were more likely to have an OB parent (70% vs 37%, P = .01). Left ventricular mass index was higher in OB/OW patients (48.8 g/m(2.7) [24.4-120.6] vs 37.7 g/m(2.7) [16.5-85.1], P = .01).
Nearly one third of ASO and Ross patients were OB/OW. Obese/overweight was not found to be related to activity restriction or early feeding practices, but was associated with parental obesity. Obese or OW patients had higher left ventricular mass. Obesity and associated comorbidities may pose additional cardiovascular risk in this unique population who underwent coronary artery reimplantation in childhood.
超过25%的先天性心脏病患者肥胖（OB）或超重（OW）。诸如活动受限和早期喂养方式等独特因素可能起作用。我们评估了一个因过去涉及冠状动脉再植入手术而易患早期冠状动脉疾病的高危队列。
纳入在我们机构接受动脉调转术或罗斯手术的患者。数据收集包括病历审查以及活动和饮食问卷。将肥胖/超重（体重指数≥85%）的比例与全国数据进行比较。评估与肥胖/超重相关的因素。
共纳入106例患者。中位年龄为14.2岁（6.0 - 19.9岁）；69%为男性。与全国数据相似，31%为肥胖/超重（对比31%，P = 无显著差异[NS]）。在活动受限方面（心脏病专家记录为27%对比27%；家长报告为38%对比42%，P = NS）、活动水平（9.8小时/周[1.7 - 41.2]对比11.5[0.8 - 52.3]，P = NS）或早期喂养方式（配方奶与母乳喂养、热量强化、管饲）方面，肥胖/超重患者与正常体重患者相比无差异。肥胖/超重患者更可能有肥胖的父母（70%对比37%，P = 0.01）。肥胖/超重患者的左心室质量指数更高（48.8 g/m(2.7)[24.4 - 1
