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. 2022 May 10:8:100390.
doi: 10.1016/j.ijcchd.2022.100390. eCollection 2022 Jun.

Increased carotid intima-media thickness and reduced health-related physical fitness in children and adolescents with coarctation of the aorta

Julia Remmele  1   2 , Laura Willinger  1   2 , Renate Oberhoffer-Fritz  2 , Peter Ewert  1   3 , Jan Müller  2
Affiliations

Increased carotid intima-media thickness and reduced health-related physical fitness in children and adolescents with coarctation of the aorta

Julia Remmele et al. Int J Cardiol Congenit Heart Dis. .

Abstract

Background: Coarctation of the Aorta (CoA) was assumed to be one of the congenital heart defects not associated with major long-term sequels. Meanwhile, it is known that there are long-term cardiovascular consequences. This study investigates the functional outcome measures in children with CoA.

Methods: 77 children (40.3% girls, 13.1 ± 3.3 years) with CoA were examined for their functional outcome measures and compared to healthy controls (CG). Carotid Intima-Media wall thickness (cIMT) was measured by ultrasound of the common carotid artery. In addition, Health-related Physical Fitness (HrPF) was assessed by five tasks of the FITNESSGRAM® and health-related quality of life (HrQoL) was analyzed with a self-report questionnaire (KINDL-R).

Results: After adjustment for age and sex and in comparison to the CG, the CoA patients showed structural changes in cIMT (CoA: 0.480 ± 0.043 mm vs CG: 0.465 ± 0.033 mm; p = 0.002) and significantly lower HrPF (z-score -0.46 ± 0.7; p < 0.001; 32nd percentile). HrQoL in children with CoA was significantly better in comparison to CG (p = 0.020).

Conclusion: Early onset of structural changes of the cIMT in children with CoA could be shown. These structural changes in combination with hypertension, which often is associated with CoA, should be the focus of structured follow-up during childhood. The children with CoA showed impaired HrPF in comparison, where the promotion of physical activity should be the key factor for improvement. Encouragingly they showed better HrQoL.

Keywords: CHD; Children with CoA; HrQoL; Physical fitness; cIMT.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Study population flow-chart. CoA: coarctation of the aorta; n: number.
Fig. 2
Fig. 2
Comparison of the intima-media wall thickness of CoA patients and Healthy controls adjusted for sex and age mm: millimetre; CoA: coarctation of the aorta; n: number; p: level of significance with p < 0.05, significant values are bold.
Fig. 3
Fig. 3
Multivariable analysis of variance model of Health-related Quality of Life in children with CoA compared with healthy controls adjusted for sex and age CoA: coarctation of the aorta; SD: standard deviation; HrQoL: health-related quality of life; p: level of significance with p < 0.05, significant values are bold.
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