Key result
Daily moderate-to-vigorous physical activity levels did not differ significantly between Fontan patients and healthy controls, but strongly correlated with peak oxygen uptake in Fontan patients (r=0.788, p=0.0035).
Why the study?
Exercise capacity is impaired in Fontan palliated patients, and increased sedentary behavior with low physical activity levels may have a greater impact on chronic heart disease patients compared to healthy controls.
Are daily physical activity levels and heart rate behavior different in Fontan patients compared to healthy controls?
Cross-Sectional (n=41)
No
Are daily physical activity levels and heart rate behavior different in Fontan patients compared to healthy controls?
Absolute Event Rate: 6.3% vs 6.6%
p-value: p=0.99
Fontan patients have alarmingly low daily physical activity levels similar to healthy controls, and their heart rate behavior does not appear to limit daily physical activity, suggesting higher intensity activities could be recommended.
Daily activity levels may relate to hypoxic exercise capacity in Fontan patients; leaves open whether activity promotion improves outcomes.
OBJECTIVE: Exercise capacity is impaired in Fontan palliated patients. The change in daily activity behaviour with an increase in sedentary lifestyle results in low physical activity levels. This might have a greater impact on patients with chronic heart disease in contrast to healthy controls. For a better understanding, we compared data from cardiopulmonary exercise testing (CPET) with heart rates and physical activity in daily life. METHODS: 21 Fontan patients and 20 age, sex and BMI matched controls underwent CPET and 5 days of daily life activity tracking with a triaxial accelerometer (wGT3x-BT, Actigraph) including heart rate monitoring with an optical heart rate sensor. RESULTS: 27% of our Fontan teenagers and 71% of the Fontan adults reached the specific WHO recommendations for moderate to vigorous physical activity (MVPA) during everyday life (EDL), without differences to controls. There was a strong correlation between MVPA and [Formula: see text] for all Fontan patients (p = 0.0035, Pearson r = 0.788). Daily MVPA correlated to peak oxygen uptake and lactate production. Up to workloads of 2 W/kg and in daily life heart rates in Fontan patients were similar to controls. CONCLUSIONS: Daily MVPA is alarmingly low without any differences between Fontan patients and controls. Heart rate behaviour was similar and does not seem to be a limiting factor for physical activity in daily life. Higher intensity activities should be implemented regularly in EDL for Fontan patients. Proof is needed as to whether sports in moderate or possibly even in vigorous activity (e.g. high-intensity interval training) improve exercise capacity the most.
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Härtel et al. (2020) conducted a cross-sectional in Fontan circulation (n=41). Fontan circulation vs. Age, sex, and BMI matched healthy controls was evaluated on Time spent in moderate-to-vigorous physical activity (MVPA) in teenagers (%) (p=0.99). Daily moderate-to-vigorous physical activity levels did not differ significantly between Fontan patients and healthy controls, but strongly correlated with peak oxygen uptake in Fontan patients (r=0.788, p=0.0035).
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