International Journal of Cardiology Congenital Heart Disease (Mar 2022)

NYHA class and cardiopulmonary exercise capacity impact self-rated health-related quality of life in young adults after arterial switch operation for transposition of the great arteries

  • Hedwig H. Hövels-Gürich,
  • Corinna Lebherz,
  • Bettina Korte,
  • Jaime F. Vazquez-Jimenez,
  • Nikolaus Marx,
  • Gunter Kerst,
  • Michael Frick

Journal volume & issue
Vol. 7
p. 100330

Abstract

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Background: Evaluating the impact of subjective physical activity status and cardiopulmonary exercise capacity on physical and mental health-related quality of life (QOL) in young adults after neonatal arterial switch operation for transposition of the great arteries. Methods: In a prospective reassessment study, 92 young adults (age 22.8 ​± ​2.6 ​y) underwent standardized evaluation of health-related QOL (SF-36), NYHA status and cardiopulmonary exercise performance (CPET). Results: Peak oxygen uptake was 33.1 ​± ​7.1 ​ml/kg/min corresponding to 84.5 ​± ​15.5% of predicted, according to the borderline subnormal range. 65% were classified as normal or borderline, 35% as impaired. 88% were NYHA class I and 12% class II, 45% exercised regularly. Despite average or even elevated mean scores for the QOL domains, more patients reported significantly poorer results, indicated by increased percentages below −2 SD for physical (5.6%), social (7.8%) and emotional role functioning (8.8%). Significant correlations existed between physical health domains and objective exercise performance (r ​= ​0.23 to 0.34, p ​= ​0.001 to 0.032) as well as NYHA class (r ​= ​0.33 to 0.46, p ​< ​0.001 to 0.002). Mental health domains were also significantly correlated with NYHA class (r ​= ​0.22 to 0.41, p ​≤ ​0.001 to 0.04) and peak oxygen uptake. Conclusions: Despite good results on average, young adults with TGA after ASO are at elevated risk for a reduced QOL. Objective exercise capacity and NYHA class are significant indicators for self-perceived physical and mental health. Applications of QOL measurement should be part of routine clinical follow up in this patient group.

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