Article Text

Download PDFPDF
Functional outcomes in children with anatomically repaired transposition of the great arteries with regard to congenital ventricular septal defect and coronary pattern
  1. Anna-Luisa Häcker1,2,
  2. Barbara Reiner1,2,
  3. Renate Oberhoffer2,
  4. Alfred Hager1,
  5. Peter Ewert1,
  6. Jan Müller1,2
  1. 1 Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, München, Germany
  2. 2 Institute of Preventive Pediatrics, Technische Universität München, München, Germany
  1. Correspondence to Ms. Anna-Luisa Häcker, Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München Lazarettstr. 36, München D-80636, Germany; anna.haecker{at}tum.de

Abstract

Objective Despite decreasing mortality, functional impairments in children with transposition of the great arteries (TGA) are still a concern. This study analyses health-related physical fitness (HRPF), arterial stiffness and health-related quality of life (HRQoL) in children with anatomically repaired TGA regarding congenital ventricular septal defect (VSD) and coronary patterns.

Patients and methods 68 children with anatomically repaired TGA with or without VSD (12.9±3.7 years, 19.1% female) were investigated between August 2014 and October 2017. HRPF was assessed by five tests of the FITNESSGRAM, arterial stiffness was measured by oscillometric measurement using Mobil-O-Graph and HRQoL was analysed with a self-report questionnaire (KINDL-R). All test results were compared with a healthy reference cohort (n=2116, 49.1% female) adjusted for sex and age.

Results Children with anatomically repaired TGA had significantly worse HRPF (z-score: −0.58±0.81, p<0.001), increased pulse wave velocity (TGA: 4.9±0.3 m/s vs healthy: 4.8±0.3 m/s, p=0.028) and central systolic blood pressure (TGA: 105.9±5.8 mm Hg vs healthy: 103.3±5.7 mm Hg, p=0.001). No difference was found for HRQoL between the two groups (total HRQoL score: TGA: 76.5±10.2 vs healthy: 75.2±10.1, p=0.315). Neither the coronary pattern nor a congenital VSD resulted in significant differences in all functional outcomes.

Conclusion Children with anatomically repaired TGA exhibit impaired HRPF and increased arterial stiffness whereas their HRQoL is normal. The underlying coronary pattern seems to have no influence on the functional outcome, nor does an accompanied congenital VSD.

  • children
  • transposition of the great arteries
  • health-related physical fitness
  • health-related quality of life
  • arterial stiffness
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors JM was responsible for conception and design of the study and for data monitoring and integrity. A-LH and BR sampled the data in the study centre. A-LH also analysed the data and drafted the manuscript. RO, AH and PE gave important inputs for revising and improving the quality of the manuscript. All authors have read and approved the final version of the manuscript.

  • Funding This study was funded by an unrestricted grant from the “Fördergemeinschaft Deutsche Kinderherzzentren e.V.“

  • Competing interests None declared.

  • Ethics approval Local ethical board of the Technical University of Munich (project number: 314/14).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.