Associations Between Exercise Capacity and Psychological Functioning in Children and Adolescents with Fontan...

Area of Science:

• Pediatric Cardiology
• Clinical Psychology
• Exercise Physiology

Background:

• Fontan circulation (FC) is associated with reduced exercise capacity and psychological challenges in pediatric patients.
• Understanding the interplay between physical and psychological health is crucial for managing FC.
• Existing research highlights the need for comprehensive assessments in this population.

Purpose of the Study:

• To investigate the relationship between exercise capacity and psychological functioning in children and adolescents with Fontan circulation.
• To identify specific psychological symptoms that correlate with objective measures of physical performance.
• To inform multidisciplinary care strategies for improving outcomes in pediatric FC patients.

Main Methods:

• A cohort of 51 pediatric patients with FC underwent cardiopulmonary exercise testing (CPET).
• Psychological functioning, including symptoms of depression, anxiety, and inattention, was assessed using the BASC-3 questionnaire (parent and self-report).
• Statistical analyses examined correlations between CPET parameters (peak VO2, heart rate recovery) and psychological measures.

Main Results:

• Parent-reported inattention negatively correlated with peak VO2 (R = -.307, P = .038), suggesting impaired exercise engagement.
• Self-reported anxiety positively correlated with heart rate recovery at 3 and 8 minutes post-exercise (R = .438, P = .004; R = .432, P = .004).
• Depression symptoms also showed positive correlations with heart rate recovery, particularly for parent-report at 3 minutes (R = .294, P = .047) and self-report at 8 minutes (R = .410, P = .007).

Conclusions:

• Inattention may negatively impact the quality of CPET performance in children with FC.
• The unexpected positive correlation between psychological distress (anxiety, depression) and rapid heart rate recovery warrants further investigation.
• These findings underscore the complex relationship between physical and psychological health in pediatric FC and suggest potential targets for intervention.