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A common congenital heart defect can affect your ability to move around, especially as you get older, regardless of whether it was corrected by surgery or previously deemed too small to receive treatment. This is according to a study published today in the Journal of American Heart Association, which is open to the journal of the American Heart Association.

A ventricular septal defect occurs when a hole in the wall that separates the pumping chambers of the heart fails to close. It can be surgically closed or left alone if found to be harmless. Researchers know that people born with a ventricular septal defect have poorer functional movement than their healthy peers. However, it was not clear whether this training capacity would degenerate with age.

A new study from Denmark suggests that people 40 years and older with ventricular septal defects – surgically repaired or not – have poorer functional exercise capacity than people born without this defect, and the difference in exercise capacity seems to increase with age.

“Most patients with congenital heart disease are discharged from follow-up in adulthood, but physical activity has been associated with many limitations,” said lead author Dr. med. Marie Maagaard, researcher at Aarhus University Hospital in Aarhus, Denmark. “These results underscore the importance of keeping adults with ventricular septal defects in follow-up programs and including exercise testing in assessing their potentially impaired function.”

Functional exercise capacity is an estimate of what a person’s heart will do regardless of other physical problems, and is based on the heart’s ability to pump sufficient amounts of oxygenated blood to replace depleted oxygen at the correct balance of normal physical activity.

The researchers evaluated differences in functional exercise capacity using standard cardiopulmonary exercise tests in 30 patients with surgically repaired ventricular septal defects, 30 other patients with small but unrepaired defects, and compared them to two groups of 30 healthy adults without heart defects who were with patients age and gender were compared. All participants were between 40 and 75 years old.

Among their findings:

  • Compared to healthy adults, exercise capacity in elderly patients with surgically repaired ventricular septal defects was 29% lower after age 40.
  • Patients in their mid-twenties with surgically repaired ventricular septal defects have an 18% reduced capacity compared to their healthy counterparts.
  • Older participants with an unrepaired ventricular septal defect had 21% less capacity; While younger patients with an unrepaired defect had a 17% lower capacity than their healthy peers.
  • Overall, all participants – both with repaired and unrepaired defects – had a significantly lower training capacity at training levels with low intensity. demonstrable at 20% of their maximum exertion. This corresponds to an impairment in stress levels such as minor daily activities.

Maagaard emphasized that the repaired group’s data also cannot be directly compared with patients who have undergone newer procedures, due to advances in surgical procedures and technology over the past few decades.

“The next step to better understand the physiology behind the results of this study could be a combination of cardiac catheterization and upright bicycle training performed on surgically repaired and unrepaired patients with ventricular septal defects and their healthy counterparts,” she said. “In addition, randomized clinical trials with possible therapeutic options are important.”

The study supports the first specific treatment for obstructive hypertrophic cardiomyopathy

More information:
American Heart Association Journal (2020).

Karen K. Stout et al. 2018 AHA / ACC Guideline for the Treatment of Adults With Congenital Heart Disease: A Task Force Report of the American College of Cardiology / American Heart Association on Guidelines for Clinical Practice, Circulation (2018). DOI: 10.1161 / CIR.0000000000000603

Provided by the American Heart Association

Quote: A common heart defect – repaired or not – can limit the ability to exercise (2020, September 23), which will be available on September 23, 2020 at limit.html was retrieved

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