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Original research article
Physical activity in adults with congenital heart disease and associations with functional outcomes
  1. Jan Müller1,
  2. Tamara Amberger1,
  3. Anika Berg1,
  4. Daniel Goeder1,
  5. Julia Remmele1,
  6. Renate Oberhoffer1,2,
  7. Peter Ewert2,
  8. Alfred Hager2
  1. 1 Institute of Preventive Pediatrics, Technische Universität München, München, Germany
  2. 2 Department of Pediatric Cardiology and Congenital Heart Disease, Technische Universität München, München, Germany
  1. Correspondence to Jan Müller, Institute of Preventive Pediatrics, Technische Universität München, Uptown München-Campus D, Georg-Brauchle-Ring 60/62, München 80992, Germany; j.mueller{at}


Objective Improved survival has yielded to growing importance of functional outcome measures in patients with congenital heart disease (CHD). This study applied the International Physical Activity Questionnaire (IPAQ) to assess self-reported physical activity (PA) in patients with CHD and their association with exercise capacity and health-related quality of life (HrQoL).

Patients and methods Prior to cardiopulmonary exercise testing (CPET), 786 consecutive patients (335 female, 31.1±11.6 years) with CHD filled in the short form of the IPAQ and the HrQoL questionnaire 36-Item Short Form.

Results In total, 393 (50.0%) patients reported health-enhancing physical activity (HEPA), 237 (30.2%) minimal activity and 156 (19.8%) inactivity. In comparison with the HEPA group, the inactive group had significant lower peak oxygen uptake (74.2%±20.7% vs 86.8%±22.3%; p<0.001) as well as lower physical (91.0%±16.9% vs 97.4%±13.6%; p<0.001) and mental (97.1%±22.2% vs 104.1%±15.6%; p<0.001) HrQoL. Independent of severity class, surgery, age, beta-blocker, pacemaker and oxygen saturation, the HEPA group in comparison with the inactive group showed significantly less probability for impairments in mental (OR: 0.21, 95% CI: 0.10 to 0.45; p<0.001) and physical (OR: 0.46, 95% CI: 0.23 to 0.92; p=0.027) HrQoL and exercise capacity (OR: 0.36, 95% CI: 0.22 to 0.59; p<0.001).

Conclusions Categorisation of patientswith CHD with the IPAQ quickly provides clinical information as HEPA patients have a less probability for impaired HrQoL and diminished exercise capacity. Nevertheless, the IPAQ cannot substitute an accelerometer-based assessment for PA, nor a CPET for exercise capacity.

  • Physical Activity
  • self-assessment
  • peak oxygen uptake
  • functional outcome

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  • Contributors JM and AH were responsible for conception and design of the study. They sampled the data in the study centre and were responsible for data monitoring and integrity. TA, AB, DG and JR analysed the data and drafted the first manuscript together with JM. PE and RO gave important input for revising the manuscript. All authors have read and approved the final version of the manuscript.

  • Competing interests None declared.

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