Department of Public Health and Clinical Medicine, Umeå University, Sweden; Department of Nursing, Umeå University, Sweden.
Institute of Medicine, The Sahlgrenska Academy, Gothenburg University, Sweden.
Int J Cardiol. 2017 Sep 15;243:174-179. doi: 10.1016/j.ijcard.2017.03.137.
In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO).
Patients with CHD (n=471) were randomly selected from the national register on CHD and categorized according to complexity of lesions - simple (n=172, 39.1±14.6years), moderate (n=212, 39±14.1years), and severe (n=87, 31.7±10.7years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression.
PAL was categorized into high (≥3 METs ≥2.5h/week, n=192) and low (≥3 METs <2.5h/week, n=279). Patients with low PAL were older (42.6 vs. 35.8years, p≤0.001), had more prescribed medications (51% vs. 39%, p=0.009), more symptoms (25% vs. 16%, p=0.02) and comorbidity (45% vs. 34% p=0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p<0.001), satisfaction with life (25.6 vs. 27.3, p=0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p<0.001) and Mental Component Summary score (MCS) (73.5 vs. 79.5, p<0.001). Complexity of heart lesion was not associated with PAL. The included PROs - separately tested in the model, together with age were associated with PAL.
PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.
一般来说，患有先天性心脏病（CHD）的成年人运动能力受损，约有 50%的人无法达到目前关于体力活动的建议。在此，我们通过患者报告的结果（PRO）分析了与 CHD 成年人体力活动水平（PAL）相关的因素。
从 CHD 国家登记处随机选择 471 例 CHD 患者，根据病变复杂性进行分类 - 简单（n=172，39±14.6 岁）、中度（n=212，39±14.1 岁）和严重（n=87，31.7±10.7 岁）。参与者完成了一份标准化问卷，测量包括 PAL 在内的 PRO 领域。在多变量逻辑回归中测试与 PAL 相关的变量。
PAL 分为高（≥3 METs≥2.5h/周，n=192）和低（≥3 METs<2.5h/周，n=279）。低 PAL 患者年龄较大（42.6 岁比 35.8 岁，p≤0.001），服用的药物更多（51%比 39%，p=0.009），症状更多（25%比 16%，p=0.02）和合并症更多（45%比 34%，p=0.02）。低 PAL 患者的生活质量评分较低（76.6 比 83.4，p<0.001）、生活满意度较低（25.6 比 27.3，p=0.003）、身体成分综合评分（PCS）较低（78.1 比 90.5，p<0.001）和心理成分综合评分（MCS）较低（73.5 比 79.5，p<0.001）。心脏病变的复杂性与 PAL 无关。单独在模型中测试的纳入 PRO 以及年龄与 PAL 相关。
PCS 和 MCS 与 PAL 的相关性强于年龄和医疗因素。因此，这些 PRO 的使用可以为 CHD 患者提供有关体力活动的个性化建议提供有价值的信息。
