NYHA Class and Cardiopulmonary Exercise Capacity Impact Self-rated Health-related Quality of Life in Young Adults After Arterial Switch Operation for Transposition of the Great Arteries

Overview

Journal Int J Cardiol Congenit Heart Dis

Date 2024 Dec 23

PMID 39712288

Authors

Hedwig H Hovels-Gurich

Corinna Lebherz

Bettina Korte

Jaime F Vazquez-Jimenez

Nikolaus Marx

Gunter Kerst

Michael Frick

Affiliations

Soon will be listed here.

Abstract

Background: Evaluating the impact of subjective physical activity status and cardiopulmonary exercise capacity on physical and mental health-related quality of life (QOL) in young adults after neonatal arterial switch operation for transposition of the great arteries.

Methods: In a prospective reassessment study, 92 young adults (age 22.8 ± 2.6 y) underwent standardized evaluation of health-related QOL (SF-36), NYHA status and cardiopulmonary exercise performance (CPET).

Results: Peak oxygen uptake was 33.1 ± 7.1 ml/kg/min corresponding to 84.5 ± 15.5% of predicted, according to the borderline subnormal range. 65% were classified as normal or borderline, 35% as impaired. 88% were NYHA class I and 12% class II, 45% exercised regularly. Despite average or even elevated mean scores for the QOL domains, more patients reported significantly poorer results, indicated by increased percentages below -2 SD for physical (5.6%), social (7.8%) and emotional role functioning (8.8%). Significant correlations existed between physical health domains and objective exercise performance (r = 0.23 to 0.34, p = 0.001 to 0.032) as well as NYHA class (r = 0.33 to 0.46, p < 0.001 to 0.002). Mental health domains were also significantly correlated with NYHA class (r = 0.22 to 0.41, p ≤ 0.001 to 0.04) and peak oxygen uptake.

Conclusions: Despite good results on average, young adults with TGA after ASO are at elevated risk for a reduced QOL. Objective exercise capacity and NYHA class are significant indicators for self-perceived physical and mental health. Applications of QOL measurement should be part of routine clinical follow up in this patient group.

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