Nutrition, Physical Activity and Sports in Children with Congenital Heart Disease

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Cardiology".

Deadline for manuscript submissions: closed (15 January 2024) | Viewed by 6775

Special Issue Editors

Division of Pediatric Cardiology, University Childrens Hospital Ulm, D-89075 Ulm, Germany
Interests: pediatric pulmonary hypertension; pediatric oncocardiology; cardiac imaging of congenital heart disease
Dr. Jannos Siaplaouras
E-Mail Website
Guest Editor
Herz Jesu Krankenhaus, 36039 Fulda, Germany
Interests: pediatric sports medicine; cardiopulmonary rehabilitation

Special Issue Information

Dear Colleagues,

In childhood, physical activity is particularly important, not only for somatic health, but also for neurologic, emotional, and psychosocial development. In addition, healthy nutrition and regular sportive activities may reduce acquired cardiovascular risk factors (i.e., arterial hypertension, obesity, diabetes) that are commonly seen in the general population and that increase the risk of metabolic disease, stroke, and coronary artery disease. 

Unfortunately, children with congenital heart disease have often reduced levels of physical activity, mainly due to overprotection from their parents and caregivers, teachers and sport trainers, and physicians and health care professionals as well as to misperceptions regarding the relative risks versus benefits of participation. This is often accompanied by unhealthy nutrition that results in a dangerous vicious cycle, which can only be suspended by a rigorous lifestyle modification.

The goal of this Special Issue is to better understand how nutrition, physical activity, and sports affect children and adolescents with congenital heart disease and to increase the available evidence related to this.

Manuscripts should address the above items in regard to:

  • Demography, etiology, and pathophysiologic aspects;
  • How to assess exercise limitations;
  • New developments in the field and in the molecular basis when appropriate;
  • Therapeutic novelties that may improve patient outcomes.
This Special Issue will accept:
  • Original, basic, and clinical articles;
  • Case studies;
  • Prospective studies;
  • Review or mini review articles.

Dr. Christian Apitz
Dr. Jannos Siaplaouras
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • children
  • adolescents
  • congenital heart disease
  • nutrition
  • physical activity
  • sports
  • cardiovascular risk
  • lifestyle
  • pediatric cardiology

Published Papers (3 papers)

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Research

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9 pages, 610 KiB  
Article
Step by Step: Evaluation of Cardiorespiratory Fitness in Healthy Children, Young Adults, and Patients with Congenital Heart Disease Using a Simple Standardized Stair Climbing Test
Children 2024, 11(2), 236; https://doi.org/10.3390/children11020236 - 12 Feb 2024
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Abstract
(1) Background: Cardiorespiratory fitness (CRF) is known to be a prognostic factor regarding long-term morbidity and mortality. This study aimed to develop a standardized Stair Climbing Test (SCT) with a reliable correlation to spiroergometry and the 6MWT which can be used in healthy [...] Read more.
(1) Background: Cardiorespiratory fitness (CRF) is known to be a prognostic factor regarding long-term morbidity and mortality. This study aimed to develop a standardized Stair Climbing Test (SCT) with a reliable correlation to spiroergometry and the 6MWT which can be used in healthy children as well as patients with congenital heart disease (CHD) and a restricted exercise capacity. (2) Methods: A total of 28 healthy participants aged 10–18 years were included. We tested the individuals’ CRF by cardiopulmonary exercise testing (CPET) on a treadmill, the 6MWT, and a newly developed Stair Climbing Test (SCT). For the SCT, we defined a standardized SCT protocol with a total height of 13.14 m to achieve maximal exercise effects while recording time and vital parameters. To compare the SCT, the 6 Min Walking Test, and CPET, we introduced an SCT-Index that included patient data (weight, height) and time. To assess the SCT’s feasibility for clinical practice, we also tested our protocol with five adolescents with complex congenital heart disease (i.e., Fontan circulation). (3) Results: A strong correlation was observed between SCT-Index and O2 pulse (r = 0.921; p < 0.001). In addition, when comparing the time achieved during SCT (tSCT) with VO2max (mL/min/kg) and VO2max (mL/min), strong correlations were found (r = −0.672; p < 0.001 and r = −0.764; p < 0.001). Finally, we determined a very strong correlation between SCT-Index and VO2max (mL/min) (r = 0.927; p = <0.001). When comparing the 6MWD to tSCT, there was a moderate correlation (r = −0.544; p = 0.003). It appears to be feasible in patients with Fontan circulation. (4) Conclusions: We were able to demonstrate that there is a significant correlation between our standardized SCT and treadmill CPET. Therefore, we can say that the SCT can be used as an easy supplement to CPET and in certain contexts, it can also be used as a screening tool when CPET is not available. The advantages would be that the SCT is a simple, quick, cost-effective, and reliable standardized (sub)maximal exercise test to evaluate CRF in healthy children on a routine basis. We can even assume that it can be used in patients with congenital heart disease. Full article
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12 pages, 992 KiB  
Article
Physical Self-Concept and Physical Activity in Children with Congenital Heart Defects—Can We Point Out Differences to Healthy Children to Promote Physical Activity?
Children 2023, 10(3), 478; https://doi.org/10.3390/children10030478 - 28 Feb 2023
Cited by 1 | Viewed by 1060
Abstract
Objective: Children with congenital heart defects (CHD) are at high risk for cardiovascular disease in addition to their congenital disease, so it is important to motivate this group of patients to live a physically active lifestyle. A potential influencing determinant of younger children’s [...] Read more.
Objective: Children with congenital heart defects (CHD) are at high risk for cardiovascular disease in addition to their congenital disease, so it is important to motivate this group of patients to live a physically active lifestyle. A potential influencing determinant of younger children’s physical performance is the physical self-concept. The objective of the present study was first to evaluate the correlation between the physical self-concept (PSC) and the participation in physical activities (PA) of a representative group of children with congenital heart disease (CHD), and second to point out differences in comparison to their healthy peer group. Methods: Using the database of PA of the S-BAHn-Study we focused on physical self-concept assessed by the German version of the Physical Self-Description Questionnaire. We compare the obtained data of children with CHD to a representative age-matched sample of 3.385 participants of the Motorik Modul Study. Results: N = 1.198 complete datasets could be included in the analyses. The mean age of patients was 11.6 ± 3.1 years. For the total cohort of patients with CHD and the reference group, PA correlated significantly with a positive PSC (p < 0.001). PA was significantly reduced in all groups of patients despite the severity of their heart defect (p < 0.001). Remarkably, PSC did not differ statistically significantly in patients with simple CHD from the reference collective (p > 0.24). Conclusions: According to this representative survey, there is a clear relation between PA and PSC in the cohort of healthy children and the group of children with CHD throughout the severity of their heart defects. Although PSC did not differ in patients with simple CHD and their healthy peer group, PA was significantly reduced. This gap invites us to reflect on how we could break new ground to promote a physically active lifestyle in children with CHD regardless of the severity of their cardiac defects. Full article
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Review

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30 pages, 2196 KiB  
Review
Effects of Sports, Exercise Training, and Physical Activity in Children with Congenital Heart Disease—A Review of the Published Evidence
Children 2023, 10(2), 296; https://doi.org/10.3390/children10020296 - 02 Feb 2023
Cited by 3 | Viewed by 4222
Abstract
Children and adolescents with congenital heart disease (CHD) should be encouraged to adopt a physically active lifestyle, ideally by participating in sports activities at school and sports clubs. Children with complex CHD or other risk factors (for example, pacemakers, cardioverter-defibrillators, channelopathies) may, however, [...] Read more.
Children and adolescents with congenital heart disease (CHD) should be encouraged to adopt a physically active lifestyle, ideally by participating in sports activities at school and sports clubs. Children with complex CHD or other risk factors (for example, pacemakers, cardioverter-defibrillators, channelopathies) may, however, need specific individualized training programs. This review article summarizes the current knowledge regarding the clinical effects of sports and exercise training on CHD and its pathophysiologic mechanisms. An evidence-based approach based on a literature search, using PubMed, Medline, CINHAL, Embase, and the Cochrane Library was conducted, last completed on 30 December 2021. In studies with 3256 CHD patients in total, including 10 randomized controlled trials, 14 prospective interventional trials, 9 observational trials, and 2 surveys, exercise training has been shown to improve exercise capacity and physical activity, motoric skills, muscular function, and quality of life. Sports and exercise training appears to be effective and safe in CHD patients. Despite being cost-efficient, training programs are currently scarcely reimbursed; therefore, support from healthcare institutions, commissioners of healthcare, and research-funding institutions is desirable. There is a strong need to establish specialized rehabilitation programs for complex CHD patients to enhance these patients’ access to this treatment intervention. Further studies may be desirable to confirm these data to investigate the impact on risk profiles and to identify the most advantageous training methodology and underlying pathophysiological mechanisms. Full article
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