Height and weight trajectories are associated with submaximal and maximal exercise capacity in children with...

Area of Science:

• Pediatrics
• Cardiology
• Exercise Physiology

Background:

• Children with congenital heart defects (CHD) often exhibit impaired growth, including reduced height and weight.
• This limited growth may indicate energy deficits that can impact physical activity levels and overall exercise capacity.
• Understanding the relationship between growth trajectories and exercise parameters is crucial for managing CHD patients.

Purpose of the Study:

• To analyze growth trajectories (height, weight, BMI z-scores) in children with CHD.
• To examine the association between identified growth patterns and exercise capacity using Bruce treadmill tests.
• To identify potential risks linked to specific growth patterns in this population.

Main Methods:

• Latent class analysis was used to identify distinct growth trajectories from birth for height, weight, and BMI z-scores.
• Linear regression models assessed exercise parameters (peak heart rate, exercise duration) in relation to growth trajectories.
• Models were adjusted for age, sex, and CHD severity in 213 children with CHD.

Main Results:

• Children with consistently below-average height trajectories had lower peak heart rates and achieved a lower percentage of predicted peak heart rate.
• Increasing weight or BMI z-score trajectories were associated with significantly lower exercise duration compared to stable or declining trajectories.
• Children with above-average weight or increasing BMI used a higher percentage of their heart rate reserve during submaximal exercise.

Conclusions:

• A trajectory of very low height z-score is linked to decreased exercise capacity in children with CHD.
• This reduced capacity may elevate the risk of morbidities associated with sedentary lifestyles.
• Further research is needed to explore mechanisms behind height deficits and their impact on physical activity.