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Generalised muscle weakness in young adults with congenital heart disease
  1. Matthias Greutmann1,
  2. Thao Lan Le2,
  3. Daniel Tobler1,
  4. Patric Biaggi1,
  5. Erwin N Oechslin1,
  6. Candice K Silversides1,
  7. John T Granton2
  1. 1Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Division of Cardiology, University of Toronto, Toronto, Canada
  2. 2Division of Respirology, Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada
  1. Correspondence to Dr Matthias Greutmann, University Hospital of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; matthias.greutmann{at}usz.ch

Abstract

Background In patients with heart failure from acquired cardiomyopathy, respiratory and skeletal muscle weakness is common and is an independent predictor for adverse events. Despite a different underlying pathology, many young adults with congenital heart disease (CHD) develop a syndrome comparable to heart failure from acquired cardiomyopathy and may be at risk for a similar skeletal muscle weakness.

Objectives To assess respiratory and skeletal muscle strength in adults with complex CHD.

Methods Respiratory and skeletal muscle function was assessed in 51 adults; 41 with complex CHD (16 tetralogy of Fallot, 11 univentricular anatomy with Fontan operation and 14 with subaortic right ventricles) and 10 controls. Maximal inspiratory (MIPs) and expiratory (MEPs) pressures, handgrip strength, lung volumes and aerobic capacity (peak VO2) were measured.

Results In patients with CHD (age 34±13 years), average% predicted MIPs, MEPs and handgrip strength were lower than in controls (77±27% vs 106±28%, 85±32% vs 116±41% and 72±15% vs 93±14%, respectively, p≤0.01). There was no significant difference in muscle weakness between CHD subgroups. In 39% of patients with CHD, the handgrip strength, and in 22%, respiratory muscle strength was <70% predicted. These patients had a significantly lower peak VO2 (50±12% vs 64±14% predicted, p=0.008).

Conclusion Respiratory and skeletal muscle weakness is common in young adults with complex CHD and similar to that found in older adults with advanced heart failure from acquired heart disease.

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Footnotes

  • MG and TLL have contributed equally to the manuscript.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University Health Network, Toronto, Canada.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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