Key result
Children with long QT syndrome had significantly lower peak oxygen uptake (33.9 vs. 40.1 mL/Kg/min) and ventilatory anaerobic threshold compared to healthy controls.
Why the study?
In children with congenital long QT syndrome, balancing exercise restrictions against physical activity promotion is challenging, and cardiorespiratory fitness, muscle fitness, and physical activity remain scarcely explored.
Does congenital long QT syndrome and its management reduce cardiorespiratory fitness, muscle fitness, and physical activity in children compared to healthy controls?
Cross-Sectional (n=40)
Yes
Does congenital long QT syndrome and its management reduce cardiorespiratory fitness, muscle fitness, and physical activity in children compared to healthy controls?
Children with long QT syndrome exhibit significantly reduced cardiorespiratory and muscle fitness compared to healthy peers despite similar daily physical activity levels, suggesting a multifactorial deconditioning that may benefit from cardiovascular rehabilitation.
May support fitness assessment in pediatric LQTS; leaves open causal mechanisms and rehabilitation effects.
Background In children with congenital long QT syndrome (LQTS), the risk of arrhythmic events during exercise commonly makes it difficult to balance exercise restrictions versus promotion of physical activity. Nevertheless, in children with LQTS, cardiorespiratory fitness, muscle fitness, and physical activity, have been scarcely explored. Materials and methods In this prospective, controlled, cross-sectional study, 20 children with LQTS (12.7 ± 3.7 years old) and 20 healthy controls (11.9 ± 2.4 years old) were enrolled. All participants underwent a cardiopulmonary exercise test, a muscular architecture ultrasound assessment, (cross-sectional area on right rectus femoris and pennation angle), a handgrip muscular strength evaluation, and a standing long broad jump test. The level of physical activity was determined using with a waist-worn tri-axial accelerometer (Actigraph GT3X). Results Peak oxygen uptake (VO 2peak ) and ventilatory anaerobic threshold (VAT) were lower in children with LQTS than in healthy controls (33.9 ± 6.2 mL/Kg/min vs. 40.1 ± 6.6 mL/Kg/min, P = 0.010; 23.8 ± 5.1 mL/Kg/min vs. 28.8 ± 5.5 mL/Kg/min, P = 0.007, respectively). Children with LQTS had lower standing long broad jump distance (119.5 ± 33.2 cm vs. 147.3 ± 36.1 cm, P = 0.02) and pennation angle (12.2 ± 2.4° vs. 14.3 ± 2.8°, P = 0.02). No differences in terms of moderate-to-vigorous physical activity were observed (36.9 ± 12.9 min/day vs. 41.5 ± 18.7 min/day, P = 0.66), but nearly all children were below the WHO guidelines. Conclusion Despite similar physical activity level, cardiorespiratory fitness and muscle fitness in children with LQTS were lower than in healthy controls. The origin of this limitation seemed to be multifactorial, involving beta-blocker induced chronotropic limitation, physical and muscle deconditioning. Cardiovascular rehabilitation could be of interest in children with LQTS with significant physical limitation.
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Souilla et al. (2023) conducted a cross-sectional in Long QT syndrome (n=40). Long QT syndrome vs. Healthy controls was evaluated on Peak oxygen uptake (VO2peak) (d -0.96, p=0.010). Children with long QT syndrome had significantly lower peak oxygen uptake (33.9 vs. 40.1 mL/Kg/min) and ventilatory anaerobic threshold compared to healthy controls.
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