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Cardiopulmonary Fitness of Preschoolers with Congenital Heart Disease: An Observational Study
Yen-Yu Chen1, Chung-Lan Kao1,2,3,4, Sheng-Hui Tuan5,6
1Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei 11221, Taiwan.
Insights
Preschoolers with congenital heart disease (CHD) show poorer cardiopulmonary fitness (CPF) compared to healthy peers. Maintaining a normal body mass index (BMI) is crucial for optimal CPF in young children.
Area of Science:
- Pediatrics
- Cardiology
- Exercise Physiology
Background:
- Improved survival rates in congenital heart disease (CHD) highlight the need to address residual functional limitations.
- Cardiopulmonary fitness (CPF) is often suboptimal in pediatric CHD survivors.
Purpose of the Study:
- To investigate cardiopulmonary fitness (CPF) in preschoolers with CHD.
- To compare CPF between children with CHD and healthy controls.
- To explore the influence of sex and body composition on CPF in young children with CHD.
Main Methods:
- Retrospective study comparing 80 preschoolers with CHD and 102 healthy controls.
- Cardiopulmonary exercise testing (CPET) was used to assess peak oxygen consumption, anaerobic threshold, and metabolic equivalents.
- Body mass index (BMI) and fat-free mass index (FFMI) were analyzed.
Main Results:
- Children with CHD exhibited significantly lower peak oxygen consumption, oxygen consumption at anaerobic threshold, and metabolic equivalent at anaerobic threshold compared to healthy peers.
- Sex-specific differences were noted, with boys with CHD showing reduced CPF, but not girls.
- Children with CHD had a lower fat-free mass index (FFMI).
- Normal BMI was associated with higher CPF measures in healthy preschoolers, while overweight or underweight children had lower values.
Conclusions:
- Cardiopulmonary fitness (CPF) deficits are evident in preschoolers with congenital heart disease (CHD).
- Early identification of CPF differences is possible in preschool-aged children.
- Maintaining a normal body mass index (BMI) is important for optimizing cardiopulmonary fitness (CPF) in young children, including those with CHD.
Abstract:
With advancements in cardiopulmonary rehabilitation over the past few decades, the survival rate of patients with congenital heart disease (CHD) has increased. However, the Cardiopulmonary fitness (CPF) of these patients is poor. Here, we aimed to investigate CPF in preschoolers with CHD (aged 4 to 6 years) using cardiopulmonary exercise testing. We retrospectively compared 102 healthy preschoolers with 80 preschoolers with CHD. The latter had lower peak oxygen consumption, oxygen consumption at anaerobic threshold and metabolic equivalent at anaerobic threshold. The same result was observed in boys with CHD, but not in girls, when sex was sub-analyzed. Considering the body composition, children with CHD had a lower fat-free mass index (FFMI) than their healthy peers. Healthy preschoolers with a normal body mass index (BMI) had higher anaerobic threshold and peak metabolic equivalent values than overweight or underweight children. This was categorized under the BMI reference of the Ministry of Health and Welfare in Taiwan. In conclusion, the CPF difference between the CHD and healthy groups was identified as early as in preschool age, and better CPF in healthy preschoolers within the normal BMI range suggests the importance of weight control in young children.
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