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Original research article
Cardiopulmonary fitness in children with congenital heart diseases versus healthy children
  1. Pascal Amedro1,2,3,4,
  2. Arthur Gavotto1,3,
  3. Sophie Guillaumont1,3,5,
  4. Helena Bertet6,7,
  5. Marie Vincenti1,2,3,5,
  6. Gregoire De La Villeon1,3,5,
  7. Charlène Bredy1,3,5,
  8. Philippe Acar8,
  9. Caroline Ovaert9,10,
  10. Marie-Christine Picot6,7,
  11. Stefan Matecki2,3
  1. 1 Paediatric and Adult Congenital Cardiology Department, M3C Regional Reference CHD Centre, University Hospital, Montpellier, France
  2. 2 Physiology and Experimental Biology of Heart and Muscles Laboratory - PHYMEDEXP, UMR CNRS 9214 - INSERM U1046, University of Montpellier, Montpellier, France
  3. 3 Physiology Department, Paediatric Functional Exploration Laboratory, University Hospital, Montpellier, France
  4. 4 Self-perceived Health Assessment Research Unit - EA 3279 - Public Health Department, University of Aix-Marseille, Marseille, France
  5. 5 Paediatric Cardiology and Rehabilitation Unit, St-Pierre Institute, Palavas-Les-Flots, France
  6. 6 Epidemiology and Clinical Research Department, University Hospital, Montpellier, France
  7. 7 Clinical Investigation Centre, INSERM U1411, Montpellier University Hospital, University of Montpellier, Montpellier, France
  8. 8 Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Toulouse University Hospital, Toulouse, France
  9. 9 Paediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, La Timone University Hospital, Marseille, France
  10. 10 INSERM UMR S910, Medical Genetic Laboratory, University of Aix-Marseille, Marseille, France
  1. Correspondence to Dr Pascal Amedro, Paediatric and Adult Congenital Cardiology Department, MontpellierUniversity Hospital, Montpellier 34295, France; p-amedro{at}


Objective We aimed to compare the cardiopulmonary fitness of children with congenital heart diseases (CHD) with that of age-adjusted and gender-adjusted controls. We also intended to identify clinical characteristics associated with maximum oxygen uptake (VO2max) in this population.

Methods and results We included in a cross-sectional multicentre study a total of 798 children (496 CHD and 302 controls) who underwent a complete cardiopulmonary exercise test (CPET). The association of clinical characteristics with VO2max was studied using a multivariate analysis. Mean VO2max in the CHD group and control represented 93%±20% and 107%±17% of predicted values, respectively. VO2max was significantly lower in the CHD group, overall (37.8±0.3vs 42.6±0.4 mL/kg/min, P<0.0001) and for each group (P<0.05). The mean VO2max decline per year was significantly higher in CHD than in the controls overall (−0.84±0.10 vs −0.19±0.14 mL/kg/min/year, P<0.01), for boys (−0.72±0.14vs 0.11±0.19 mL/kg/min/year, P<0.01) and for girls (−1.00±0.13 vs −0.55±0.21 mL/kg/min/year, P=0.05). VO2max was associated with body mass index, ventilatory anaerobic threshold, female gender, restrictive ventilatory disorder, right ventricle systolic hypertension, tricuspid regurgitation, the number of cardiac catheter or surgery procedures, and the presence of a genetic anomaly.

Conclusions Although the magnitude of the difference was not large, VO2max among children with CHD was significantly lower than in normal children. We suggest performing CPET in routine follow-up of these patients.

Trial registration number NCT01202916; Post-results.

  • congenital heart disease
  • cardiac rehabilitation

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  • Contributors Study concept and design: PA, M-CP, SM. Acquisition, analysis or interpretation of data: PA, AG, HB, MV, SG, CB, GDLV, CO, PhA, M-CP, SM. Drafting of the manuscript: PA, M-CP, AG, HB. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: M-CP, HB. Obtained funding: PA. Administrative, technical or material support: PA, AG. Study supervision: PA, AG, MC-P, SM.

  • Funding Montpellier University Hospital Clinical Research Program (PHRC 8422) funded this study.

  • Competing interests None declared.

  • Ethics approval The South Mediterranean IV Ethics Committee, Montpellier, France, approved the study on 7 July 2009 (reference number 2009-A00423-54).

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

  • Correction notice Since this paper was first published online the study limitation section has been edited. The sentence ' in the French CHDregistry' has been updated to ’in the French CHD registry EPICARD).