Cardiopulmonary Fitness and Physical Activity Among Children and Adolescents With Inherited Cardiac Disease

Abstract

IMPORTANCE Historical restrictions on children with inherited cardiac arrhythmia or cardiomyopathy have been implemented to mitigate the potential risk of sudden death, but these limitations can be detrimental to overall health and cardiopulmonary fitness. OBJECTIVES To evaluate cardiopulmonary fitness and physical activity among children with inherited cardiac disease and identify the factors associated with maximum oxygen uptake (V̇ O2max) in this population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, multicenter, prospective controlled study was conducted in 7 tertiary care expert centers for inherited cardiac disease in France from February 1, 2021, to June 20, 2023, with a 2-week follow-up. Participants included 100 children and adolescents aged 6 to 17 years with inherited cardiac arrhythmia or cardiomyopathy who were compared with 107 sex- and age-matched controls. MAIN OUTCOMES AND MEASURES Maximum oxygen uptake was assessed using cardiopulmonary exercise testing, and results were expressed using pediatric reference z score values. The main determinants of V̇ O2max included clinical (New York Heart Association [NYHA] functional class, treatment, echocardiographic, and electrocardiogram variables), functional (cardiopulmonary exercise test parameters), sociodemographic (sex, schooling, and parents’ education), and behavioral (physical activity and motivation) characteristics. RESULTS A total of 100 patients (mean [SD] age, 12.7 [3.1] years; 52 boys [52.0%]) and 107 controls (mean [SD] age, 11.7 [3.3] years; 54 boys [50.5%]) were included. The V̇ O2max was lower in patients than controls, expressed as z scores (mean [SD] score, −1.49 [1.48] vs −0.16 [0.97]; P