Impaired grip strength in children with congenital heart disease

2021 ◽  
pp. archdischild-2020-319955
Author(s):  
Michael Meyer ◽  
Yi Wang ◽  
Leon Brudy ◽  
Anna-Luisa Häcker ◽  
Thorsten Schulz ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Grip Strength ◽  
Congenital Heart ◽  
Healthy Controls ◽  
Z Score ◽  
Motor Tasks ◽  
Health Related ◽  
Cavopulmonary Connection ◽  
Lower Grip

ObjectivesGrip strength is known to be reduced in adults with congenital heart disease (CHD). This study compared grip strength in paediatric patients with CHD with healthy controls and determined a possible association between grip strength and health-related physical fitness (HRPF).MethodsGrip strength and HRPF were assessed in 569 children (12.4 years, 95% CI 12.16 to 12.72; 238 girls) with various CHD and compared with 2551 healthy controls (11.4 years, 95% CI 11.3 to 11.5; 1424 girls). Grip strength was determined as the maximum value of three repetitions with each hand. HRPF was tested by five motor tasks (FITNESSGRAM) and converted into an SD score (z-score).ResultsAfter adjusting for age, sex and weight, children with CHD showed significantly lower grip strength compared with healthy controls (CHD: 20.8 kg, 95% CI 20.4 to 21.2; controls: 24.5 kg, 95% CI 24.3 to 24.8). CHD subgroup analysis also revealed significantly lower grip strength than the controls, with the lowest values in patients with total cavopulmonary connection (19.1, 95% CI 18.0 to 20.2). Children with complex CHD showed the lowest values with 19.19.8 kg (95% CI 19.2 to 20.4), those with moderate 20.7 kg (95% CI 19.9 to 21.4) and those with simple 22.5 kg (95% CI 21.6 to 23.3), respectively. HRPF was also lower (z-score: −0.46, 95% CI −0.49 to –0.35) compared with healthy controls and poorly associated with grip strength (r=0.21).ConclusionsGrip strength is already reduced in children with CHD and poorly associated with HRPF. This suggests that grip strength and HRPF are different domains and have to be assessed separately.

scholarly journals Association between Objectively Measured Physical Activity and Arterial Stiffness in Children with Congenital Heart Disease

2021 ◽  
Vol 10 (15) ◽  
pp. 3266
Author(s):  
Laura Willinger ◽  
Leon Brudy ◽  
Renate Oberhoffer-Fritz ◽  
Peter Ewert ◽  
Jan Müller
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Rate ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Congenital Heart ◽  
Z Score ◽  
Objectively Measured

Background: The association between physical activity (PA) and arterial stiffness is particularly important in children with congenital heart disease (CHD) who are at risk for arterial stiffening. The aim of this study was to examine the association between objectively measured PA and arterial stiffness in children and adolescents with CHD. Methods: In 387 children and adolescents with various CHD (12.2 ± 3.3 years; 162 girls) moderate-to-vigorous PA (MVPA) was assessed with the “Garmin vivofit jr.” for 7 consecutive days. Arterial stiffness parameters including pulse wave velocity (PWV) and central systolic blood pressure (cSBP) were non-invasively assessed by oscillometric measurement via Mobil-O-Graph®. Results: MVPA was not associated with PWV (ß = −0.025, p = 0.446) and cSBP (ß = −0.020, p = 0.552) in children with CHD after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents. Children with CHD were remarkably active with 80% of the study population reaching the WHO recommendation of average 60 min of MVPA per day. Arterial stiffness did not differ between low-active and high-active CHD group after adjusting for age, sex, BMI z-score, peripheral systolic blood pressure, heart rate and hypertensive agents (PWV: F = 0.530, p = 0.467; cSBP: F = 0.843, p = 0.359). Conclusion: In this active cohort, no association between PA and arterial stiffness was found. Longer exposure to the respective risk factors of physical inactivity might be necessary to determine an impact of PA on the vascular system.

scholarly journals Health-Related Quality of Life and Congenital Heart Disease in Australia

2012 ◽  
Vol 21 ◽  
pp. S293
Author(s):  
K. Eagleson ◽  
R. Justo ◽  
F. Boyle ◽  
R. Ware ◽  
S. Johnson
Keyword(s):  
Quality Of Life ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract 11740: Fetal and Neonatal Markers of Neurodevelopmental Outcome in Congenital Heart Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ismee A Williams ◽  
Howard Andrews ◽  
Michael M Myers ◽  
William Fifer
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Infant Development ◽  
Umbilical Artery ◽  
Neurodevelopmental Outcome ◽  
Abdominal Circumference ◽  
Temporal Region ◽  
Z Score ◽  
The Right

Objectives: Children with congenital heart disease (CHD) are at risk for abnormal neurodevelopment (ND). We evaluated associations between fetal Doppler and biometry measures, neonatal electroencephalogram (EEG) and 18-month ND. Methods: Fetuses with hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and tetralogy of Fallot (TOF) had middle cerebral (MCA) and umbilical artery (UA) Doppler velocities, as well as biometry such as head (HC) and abdominal circumference (AC), prospectively recorded at 20-25 (F1), 26-32 (F2), and 33-39 (F3) wks gestational age (GA). Pulsatility indices (PI) with GA-derived z-scores and cerebral-to-placental resistance (CPR) ratios were calculated. Neonatal high-density EEG was preformed preoperatively and the Bayley Scales of Infant Development-III were assessed at 18-months. Factor analysis was used to reduce the number of EEG predictors used in regression analysis. Results: Among 56 CHD fetuses (N=19 HLHS, N=16 TGA, N=21 TOF) who underwent preoperative EEG, ND scores are available for 33 to date. Cardiac subtype was highly associated with EEG and was considered in all models. Cognition scores were predicted by CPR< 1 ever (B=-15.7, P=0.002) and HC/AC at F2 (B=-130, P=0.013, R 2 =0.42). Language scores were predicted by UA PI z-score at F1 (B=-9.6, P=0.005, R 2 =0.27). Motor scores were predicted by UA PI z-score at F1 (B=-3.9, P=0.085), HLHS (B=-15, P<0.001), EFW%ile (B=0.374, P=0.007), and delta band right parietal and right temporal log power in active sleep (B=3.9, P=0.045, R 2 =0.61). Conclusion: Lower umbilical artery pulsatility at 20-25 wks GA was associated with higher 18-month Language and Motor scores. A diagnosis of HLHS predicted poorer Motor scores. Increased EEG power in the parietal and temporal region of the right brain predicted higher Motor scores. A larger abdomen relative to head at 26-32 wks was associated with improved cognition while diminished cerebrovascular compared with placental resistance predicted poorer cognition, similar to what has been observed in the growth restricted fetus. Further investigation is needed to confirm these hypothesis-generating findings.

The association between feeding protocol compliance and weight gain following high-risk neonatal cardiac surgery

2019 ◽  
Vol 29 (5) ◽  
pp. 594-601 ◽  
Author(s):  
Jamie M. Furlong-Dillard ◽  
Benjamin J. Miller ◽  
Kathy A. Sward ◽  
Alaina I. Neary ◽  
Trudy L. Hardin-Reynolds ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Weight Gain ◽  
High Risk ◽  
Congenital Heart ◽  
Clinical Severity ◽  
Z Score ◽  
Protocol Adherence ◽  
Feeding Protocol ◽  
Weight For Age

AbstractBackground:Children with congenital heart disease are at high risk for malnutrition. Standardisation of feeding protocols has shown promise in decreasing some of this risk. With little standardisation between institutions’ feeding protocols and no understanding of protocol adherence, it is important to analyse the efficacy of individual aspects of the protocols.Methods:Adherence to and deviation from a feeding protocol in high-risk congenital heart disease patients between December 2015 and March 2017 were analysed. Associations between adherence to and deviation from the protocol and clinical outcomes were also assessed. The primary outcome was change in weight-for-age z score between time intervals.Results:Increased adherence to and decreased deviation from individual instructions of a feeding protocol improves patients change in weight-for-age z score between birth and hospital discharge (p = 0.031). Secondary outcomes such as markers of clinical severity and nutritional delivery were not statistically different between groups with high or low adherence or deviation rates.Conclusions:High-risk feeding protocol adherence and fewer deviations are associated with weight gain independent of their influence on nutritional delivery and caloric intake. Future studies assessing the efficacy of feeding protocols should include the measures of adherence and deviations that are not merely limited to caloric delivery and illness severity.

Sign in / Sign up

Export Citation Format

Share Document