NYHA III-IV class increased SMR to 5.5, severe lesions with NYHA III-IV had SMR 17.2, and regular physical activity normalized SMR in adults with congenital heart disease.
Does regular physical activity reduce death or heart transplantation in adults with congenital heart disease?
NYHA class and physical activity level are strong prognostic markers in adult congenital heart disease, with regular physical activity associated with a mortality risk comparable to the general population.
Absolute Event Rate: 0% vs 0%
Abstract Background When more patients with congenital heart disease reach adult age, there is a need of new prognostic markers. NYHA class and physical activity level, both related to exercise capacity, are potential prognostic variables. Here we have calculated the SMR in NYHA class and physical activity level. Methods This a register-based study where 9,303 patients with adult congenital heart disease (median age at baseline 28 years, IQR 20-44, 48 % women) were followed for 8.8±5.6 years. The outcome was death or heart transplantation. The standardized mortality ratio (SMR) was calculated as the ratio between observed deaths in the study cohort and the expected deaths if the general population had the same age and gender distribution, using data in the Human Mortality Database. The lesions were stratified into the three groups; mild, moderate and severe, based on the heart lesion. Results In total 552 deaths occurred. In all patients, SMR was 1.8 (1.5-2.1) and in NYHA III-IV 5.5 (4.0-7.3). The same pattern was seen in mild, moderate and severe ACHD. In patients with severe lesions and NYHA I, SMR was 7.0(4.5-10.2) and 17.2(10.7-25.9) in NYHA III-IV. Patients who exercised regularly had a consistent lower SMR than those who did not. In patients with regular physical activity, there was no difference in SMR compared to the general population. In patients with the lowest physical activity level, the SMR was 3.2 (2.6-3.8) for all lesions. Conclusion Easily available clinical variables such as NYHA class and physical activity level are potential markers for prognosis in adult congenital heart disease.
Johansson et al. (Sat,) reported a other. NYHA III-IV class increased SMR to 5.5, severe lesions with NYHA III-IV had SMR 17.2, and regular physical activity normalized SMR in adults with congenital heart disease.