Functional outcome in contemporary children with total cavopulmonary connection - Health-related physical fitness, exercise capacity and health-related quality of life.
OBJECTIVE
Children and adolescents with an univentricular heart after total cavopulmonary connection (TCPC) have functional impairments. This study assesses health-related physical fitness (HRPF) and exercise capacity, as well as their relation to health-related quality of life (HRQoL) in patients with an univentricular heart after total-pulmonary connection (TCPC).


PATIENTS AND METHODS
Between July 2014 and October 2016 a total of 78 children and adolescents with TCPC (12.0±3.2years, 21 female) performed a motor test including five tasks for strength and flexibility during their routine follow-up appointment. They also underwent a symptom limited cardio-pulmonary exercise test and filled in a HRQoL questionnaire (KINDL-R). Patients' data were compared to a recent sample of healthy children (n=1650, 12.6±2.4years, 49% female).


RESULTS
Multivariable regressions corrected for sex, age and BMI showed that TCPC patients achieved 12.4 repetitions of curl-ups (p<0.001) and 2.6 push-ups (p=0.010) less than healthy counterparts. They had impairments in trunk (-8.5cm; p<0.001), shoulder (-7.5cm; p<0.001) and lower limb flexibility (-4.7cm; p<0.001). Peak oxygen uptake was reduced to 34.8±7.5ml/min/kg and 77.7% respectively, compared to peers (p<0.001). Ventilatory efficiency was also impaired (healthy: 27.5±2.9 vs. TCPC: 31.6±3.3; p<0.001). HRQoL did not differ significantly (p=0.233).


CONCLUSIONS
Children and adolescents with TCPC still present impaired HRPF and exercise capacity whereas HRQoL is similar to healthy peers. Since low HRPF may yield to worse motor competence and exercise capacity, early screening for HRPF and early treatment, if indicated, is recommended.
['Hock|Julia|J|', 'Reiner|Barbara|B|', 'Neidenbach|Rhoia C|RC|', 'Oberhoffer|Renate|R|', 'Hager|Alfred|A|', 'Ewert|Peter|P|', 'Müller|Jan|J|']
D000293:Adolescent D002648:Child D015331:Cohort Studies D005080:Exercise Test D017079:Exercise Tolerance D005260:Female D005500:Follow-Up Studies D018610:Heart Bypass, Right D006330:Heart Defects, Congenital D006801:Humans D008297:Male D010809:Physical Fitness D011788:Quality of Life D016896:Treatment Outcome
Univentricular heart Peak oxygen uptake Motor competence Congenital heart disease Fontan