Sport Participation In Children With Congenital Heart Disease

PURPOSE: Participation in sport benefits the growth and development of children and can affect activity habits over the lifespan. Children with congenital heart disease (CHD) may be limited in their ability to participate in sport due to delayed gross motor development, physiological, psychological, or medical limitations. We sought to understand how many of our CHD patients participate in sport. METHODS: A single-centre retrospective review (May 2016-October 2023) was conducted in CHD patients with a cardiopulmonary exercise test (CPET) and an assessment of sport participation. Criteria for a maximal CPET test included: a respiratory exchange ratio > 1.0, and/or a peak heart rate > 200 bpm. VO2peak and HR z-scores were calculated. Sport participation was recorded based on frequency, intensity, time, and type and was categorized into 3 groups: Participation (at least 2 days/week); No sport participation but regular activity; No participation. Frequency tables were generated. A one-way ANOVA with a Tukey post-hoc test was used to determine differences between groups. P < 0.05 was considered statistically significant. RESULTS: Seventy-four CHD patients were included: 8 with aortic valve disease (no intervention); 12 with coarctation; 6 following the Ross procedure for aortic valve stenosis; 25 with tetralogy of Fallot, 11 with transposition of the great arteries; and 12 with Fontan palliation. Forty-six percent of our study cohort were involved in sport, 19% regularly attended the gym or achieved >10,000 steps/day and 35% did not participate in any sport. There was no difference in HR z-score (-0.77 vs -1.03 vs -0.73; p ≥ 0.05) or peak HR (190 vs 186 vs 183 bpm; p ≥ 0.05) for those who participate, do not participate but are active, or those who do not participate in sport, respectively. VO2peak z-score was different between groups (p = 0.002) with the lowest z-score in those who do not participate in sport compared to those who do participate in sport (-1.63 vs -0.77; p < 0.001). CONCLUSIONS: Thirty-five percent of our patient group did not participate in sport and had a lower VO2peak z-score compared to those who did participate in sport. Understanding the barriers to sport participation in this population may provide important insight and direct intervention strategies.