Physical activity is associated with better vascular function in children and adolescents with congenital heart disease

Abstract Background Aortic stiffness is an important marker of cardiovascular risk and is elevated in children and adolescents with congenital heart disease (CHD) compared to healthy children; however, in children with CHD, little is known about the interaction between aortic stiffness and physical activity - a key determinant of aortic stiffness. Methods For this cross-sectional cohort study, we recruited children and adolescents aged 9-16 years with moderate-to-complex CHD from BC Children’s Hospital and travelling partnership clinics across the province of British Columbia and the Yukon territory. Mean daily minutes of moderate-to-vigorous physical activity was objectively assessed using an ActiGraph accelerometer worn over the right hip during waking hours for 7 days. Aortic pulse wave velocity (cm/s) was measured using standard 2-dimensional echocardiography and Doppler ultrasound. Results Participants (n=104, 61% male; 85% consent rate) had a mean (SD) age of 12.4 (2.4) years. Daily moderate-to-vigorous physical activity was 46.7 (20.0) minutes/day, with 25% meeting guidelines of ≥60 minutes of moderate-to-vigorous physical activity per day. Mean (SD) aortic pulse wave velocity was 490.5 (161.9) cm/s, which was not significantly different between cardiac diagnoses. Higher levels of moderate-to-vigorous physical activity were associated with lower aortic pulse wave velocity (r=-0.226, p=0.021). Conclusion In children and adolescents with CHD, higher levels of physical activity are associated with better vascular function. Given this association, promoting physical activity should be a high priority in the care of children and adolescents with CHD.