Investigators from Children’s National Health System conducted a cross-sectional survey of individuals with known congenital heart disease (CHD) to determine the type and intensity of their sports participation and how this participation affected their quality of life (QOL). Individuals who were 13–30 years old and had a billing code for CHD at an outpatient visit at the investigators’ institution during a 3-year period were eligible. Eligible individuals were either sent a survey to complete by mail or were approached during a subsequent outpatient visit. The survey contained questions about demographics, frequency of physical activity, type and intensity of sports participation, type of sports restrictions, as well as QOL, which was measured using the PedsQL 4.0 (scored 0–100, with 100 representing high QOL).1 Clinical data from enrolled participants were gathered from their medical records and included underlying CHD diagnosis and severity (classified as mild, moderate, or severe), previous cardiac interventions, comorbid medical conditions, body mass index (BMI), and sports participation recommendations documented by the primary cardiologist. Sports participation recommendations were compared to recommended guidelines.2,3
The primary study outcomes were PedsQL scores and BMI. The primary exposure variables included frequency of physical activity and type of sports participation (categorized as none, recreational, or competitive). Multivariable models were used to assess the association of these variables with the 2 study outcomes after adjusting for age, sex, severity of CHD, and presence of comorbidities.
There were 177 participants included in analysis. The mean age of the cohort was 19.5 years; 47% were male; 31% had mild CHD, 40% moderate CHD, and 29% severe CHD. Overall, 52% reported playing competitive sports, 25% recreational sports, and 23% did not participate in sports. The mean BMI of all respondents was 23.6 and the mean PedsQL score was 82.1.
Of all respondents, 63% reported that they could play any sport they wanted, 27% reported being restricted from at least 1 sport, and 10% were not interested in participating in sports. Only 44% of respondents had sports participation recommendations documented by a cardiologist, of which 74% were consistent with current guidelines (of those not consistent, one fourth were more restrictive, three fourths were less restrictive). Patients with mild CHD were more likely to participate in competitive sports than patients with moderate or severe CHD (69% vs 44% and 45%, respectively; P = .009). In multivariable analysis, participation in competitive sports was associated with a significantly higher total PedsQL score (P = .003), lower BMI (P = .02), and higher predicted oxygen consumption (P = .002) compared to no sport participation.
The authors conclude that individuals with CHD commonly participate in competitive sports and many do so contrary to current participation guidelines. Participation is associated with improved...