Physical activity in adults with congenital heart disease and associations with functional outcomes

Objective Improved survival has yielded to growing importance of functional outcome measures in patients with congenital heart disease (CHD). This study applied the International Physical Activity Questionnaire (IPAQ) to assess self-reported physical activity (PA) in patients with CHD and their association with exercise capacity and health-related quality of life (HrQoL). Patients and methods Prior to cardiopulmonary exercise testing (CPET), 786 consecutive patients (335 female, 31.1+/-11.6 years) with CHD filled in the short form of the IPAQ and the HrQoL questionnaire 36-Item Short Form. Results In total, 393 (50.0%) patients reported health-enhancing physical activity (HEPA), 237 (30.2%) minimal activity and 156 (19.8%) inactivity. In comparison with the HEPA group, the inactive group had significant lower peak oxygen uptake (74.2%+/-20.7% vs 86.8%+/-22.3%; p<0.001) as well as lower physical (91.0%+/-16.9% vs 97.4%+/-13.6%; p<0.001) and mental (97.1%+/-22.2% vs 104.1%+/-15.6%; p<0.001) HrQoL. Independent of severity class, surgery, age, beta-blocker, pacemaker and oxygen saturation, the HEPA group in comparison with the inactive group showed significantly less probability for impairments in mental (OR: 0.21, 95% CI: 0.10 to 0.45; p<0.001) and physical (OR: 0.46, 95% CI: 0.23 to 0.92; p=0.027) HrQoL and exercise capacity (OR: 0.36, 95% CI: 0.22 to 0.59; p<0.001). Conclusions Categorisation of patients with CHD with the IPAQ quickly provides clinical information as HEPA patients have a less probability for impaired HrQoL and diminished exercise capacity. Nevertheless, the IPAQ cannot substitute an accelerometer-based assessment for PA, nor a CPET for exercise capacity.