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Ann Thorac Surg 2006;81:665-670
© 2006 The Society of Thoracic Surgeons
a Division of Pediatric Cardiology, University of Liège, Belgium
b Mathematical Institute, University of Liège, Belgium
c Department of Pediatric Cardiology, Aachen University of Technology, Aachen, Germany
Accepted for publication July 13, 2005.
* Address correspondence to Dr Massin, Division of Pediatric Cardiology, CHR Citadelle (University of Liège), Boulevard du 12è de Ligne, 1, Liège B-4000, Belgium (Email: martial.massin{at}chrcitadelle.be).
BACKGROUND: Physical inactivity is a major atherosclerosis risk factor. The exercise tolerance is usually excellent after neonatal arterial switch operation, but those patients in whom coronary anomalies remain the main late complication, risk developing atherosclerotic coronary disease owing to perceived physical activity restrictions.
METHODS: We investigated physical activity patterns of 52 unselected children 7 to 14 years after neonatal arterial switch operation for transposition of the great arteries by 24-hour continuous heart rate monitoring. The percentage of heart rate reserve was used to measure the amounts of activities. Comparisons were made with 35 children with repaired atrial or ventricular septal defect and with 127 age-matched healthy children.
RESULTS: Children after arterial switch operation accumulated 167.3 ± 70.6, 25.3 ± 12.9, and 15.7 ± 11.3 minutes a day (mean ± SD) of light, moderate, and vigorous physical activities, respectively. At the same activity levels, children with repaired septal defect accumulated 165.2 ± 82.2, 26.2 ± 11.7, and 16.2 ± 9.1 minutes a day, and their healthy peers 164.8 ± 74.5, 31.8 ± 13.9, and 21.9 ± 11.3 minutes a day. Both cardiac groups were significantly less active than the control group when considering moderate (p = 0.026) and vigorous activities (p = 0.006). Only 19% and 27% of the children after arterial switch operation engaged, respectively, in more than 30 minutes a day of moderate activity and 20 minutes a day of vigorous activity.
CONCLUSIONS: Children after arterial switch operation, just like other cardiac children, do not meet the guidelines for physical activity. We should encourage regular physical activity to offset adult sedentary behavior and to prevent atherosclerotic cardiovascular disease in those patients whose long-term function of the coronary arteries remains a matter of concern.
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