Remmele Julia, Willinger Laura, Oberhoffer-Fritz Renate, Ewert Peter, Müller Jan
Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Germany.
Institute of Preventive Pediatrics Technical University Munich, Munich, Germany.
Int J Cardiol Congenit Heart Dis. 2022 May 10;8:100390. doi: 10.1016/j.ijcchd.2022.100390. eCollection 2022 Jun.
Coarctation of the Aorta (CoA) was assumed to be one of the congenital heart defects not associated with major long-term sequels. Meanwhile, it is known that there are long-term cardiovascular consequences. This study investigates the functional outcome measures in children with CoA.
77 children (40.3% girls, 13.1 ± 3.3 years) with CoA were examined for their functional outcome measures and compared to healthy controls (CG). Carotid Intima-Media wall thickness (cIMT) was measured by ultrasound of the common carotid artery. In addition, Health-related Physical Fitness (HrPF) was assessed by five tasks of the FITNESSGRAM® and health-related quality of life (HrQoL) was analyzed with a self-report questionnaire (KINDL-R).
After adjustment for age and sex and in comparison to the CG, the CoA patients showed structural changes in cIMT (CoA: 0.480 ± 0.043 mm vs CG: 0.465 ± 0.033 mm; p = 0.002) and significantly lower HrPF (z-score -0.46 ± 0.7; p < 0.001; 32nd percentile). HrQoL in children with CoA was significantly better in comparison to CG (p = 0.020).
Early onset of structural changes of the cIMT in children with CoA could be shown. These structural changes in combination with hypertension, which often is associated with CoA, should be the focus of structured follow-up during childhood. The children with CoA showed impaired HrPF in comparison, where the promotion of physical activity should be the key factor for improvement. Encouragingly they showed better HrQoL.
主动脉缩窄（CoA）曾被认为是一种与重大长期后遗症无关的先天性心脏缺陷。与此同时，已知存在长期心血管后果。本研究调查CoA患儿的功能结局指标。
对77例CoA患儿（40.3%为女孩，年龄13.1±3.3岁）进行功能结局指标检查，并与健康对照组（CG）进行比较。通过超声测量颈总动脉的颈动脉内膜中层厚度（cIMT）。此外，通过FITNESSGRAM®的五项任务评估健康相关身体素质（HrPF），并使用自我报告问卷（KINDL-R）分析健康相关生活质量（HrQoL）。
在对年龄和性别进行调整后，与CG相比，CoA患者的cIMT出现结构变化（CoA：0.480±0.043mm vs CG：0.465±0.033mm；p = 0.002），且HrPF显著降低（z评分-0.46±0.7；p < 0.001；第32百分位数）。与CG相比，CoA患儿的HrQoL显著更好（p = 0.020）。
可显示CoA患儿cIMT结构变化的早期发生。这些结构变化与通常与CoA相关的高血压相结合，应成为儿童期结构化随访的重点。相比之下，CoA患儿的HrPF受损，其中促进身体活动应是改善的关键因素。令人鼓舞的是，他们的HrQoL更好。
