Callegari Alessia, Faeth Kathrin, Pfammatter Charlène, Jung Ruedi, Berger Florian, Burkhardt Barbara, Valsangiacomo Buechel Emanuela R
University Children's Hospital Zurich, Pediatric Heart Centre, Zurich, Switzerland.
Children's Research Centre, Zurich, Switzerland.
Front Cardiovasc Med. 2022 Jun 14;9:915810. doi: 10.3389/fcvm.2022.915810. eCollection 2022.
Fontan patients tend to have reduced physical exercise capacity. This study investigates physical activity (PA) and its relationship to exercise capacity, heart rates, cardiac function, biomarkers, health-related quality of life (HRQoL), and sleep quality.
Cardiovascular magnetic resonance (CMR), exercise testing (CPET), 24 h-ECG, and blood samples were prospectively performed in 38 patients, age 13 (11-16) years. PA was assessed by accelerometer during 7 consecutive days. HRQoL was self-assessed with KIDSCREEN-27 and SF-36 according to patients' age; sleep quality with Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI).
Daily moderate to vigorous physical activity (MVPA) was in median (IQR) 40 (28-57) mins; 7/38 (18%) patients reached the recommended 60 mins/day of MVPA. MVPA did not correlate with gender, age, single ventricle morphology, time from Fontan, heart rate, ventricular volumes, and ejection fraction at CMR, biomarkers, or CPET. Physical wellbeing ( = 0.33, = 0.04), autonomy ( = 0.39, = 0.03), and social support ( = 0.43, = 0.009) assessed using the KIDSCREEN-27, and both physical ( = 0.57, = 0.03) and mental ( = 0.54, = 0.04) domains of the SF-36 questionnaire correlated with daily minutes of MVPA. PSQI global sleeping score ( = -0.7, = 0.007), and PSQ scales for behavior ( = -0.36; = 0.03) correlated with daily minutes of MVPA.
Only 18% of the Fontan patients meet the recommendation for daily MVPA. Measures of exercise capacity, cardiac function or chronotropic competence are not correlated to daily physical activity. In contrast, HRQoL and sleep quality seem to be associated with regular physical activity.
Fontan手术患者的身体运动能力往往会下降。本研究调查了体力活动（PA）及其与运动能力、心率、心脏功能、生物标志物、健康相关生活质量（HRQoL）和睡眠质量的关系。
对38例年龄为13（11 - 16）岁的患者进行了前瞻性心血管磁共振成像（CMR）、运动测试（CPET）、24小时心电图监测和血液样本采集。通过加速度计连续7天评估PA。根据患者年龄，使用儿童生活质量量表（KIDSCREEN - 27）和简明健康调查问卷（SF - 36）进行HRQoL的自我评估；使用儿童睡眠问卷（PSQ）和匹兹堡睡眠质量指数（PSQI）评估睡眠质量。
每日中度至剧烈体力活动（MVPA）的中位数（四分位间距）为40（28 - 57）分钟；38例患者中有7例（18%）达到了建议的每日60分钟MVPA。MVPA与性别、年龄、单心室形态、Fontan手术后时间、心率、CMR时的心室容积和射血分数、生物标志物或CPET均无相关性。使用KIDSCREEN - 27评估的身体健康（r = 0.33，P = 0.04）、自主性（r = 0.39，P = 0.03）和社会支持（r = 0.43，P = 0.009），以及SF - 36问卷的身体（r = 0.57，P = 0.03）和心理（r = 0.54，P = 0.04）领域均与每日MVPA分钟数相关。PSQI总体睡眠评分（r = -0.7，P = 0.007）和PSQ行为量表（r = -0.36；P = 0.03）与每日MVPA分钟数相关。
只有18%的Fontan手术患者达到了每日MVPA的建议量。运动能力、心脏功能或变时能力的指标与日常体力活动无关。相比之下，HRQoL和睡眠质量似乎与规律的体力活动有关。
