Document Detail


Detrimental impact of socioeconomic status on exercise capacity in adults with congenital heart disease.
MedLine Citation:
PMID:  21868115     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the relationship between socioeconomic status (SES), access to physical activity resources, urban-rural dwelling, levels of pollution and exercise capacity in adult congenital heart disease (ACHD) patients. BACKGROUND: Exercise intolerance is prevalent in ACHD and the contributing factors are poorly understood. METHODS: A total of 1268 ACHD patients living in England who underwent cardiopulmonary exercise testing at our center were included. Neighborhood deprivation (English Indices of Deprivation), urban-rural dwelling, availability of green space, distance to the closest gym/fitness center and levels of pollution were estimated based on administrative data. RESULTS: Urban-rural dwelling, availability of green space and levels of pollution were unrelated to exercise capacity. Lower SES was associated with a significantly lower peak oxygen consumption (P<0.002) and heart rate reserve (P<0.004). This association was non-linear and most pronounced in ACHD patients with cardiac defects of medium complexity living in the most socioeconomically disadvantaged communities. Low SES was associated with higher prevalence of diabetes (P=0.015) and smoking (P=0.01). Coronary artery disease was rare in this young population and low SES was found to be related to exercise capacity independently of the presence of coronary artery disease. CONCLUSIONS: Living in poorer areas is associated with exercise intolerance in contemporary ACHD patients. Although low SES is linked to traditional cardiovascular risk factors, the deleterious effects of SES on exercise capacity seem to be only partially mediated via coronary artery disease. Reducing social inequalities in ACHD patients may have a positive effect on quality of life and long-term prognostic implications.
Authors:
Gerhard-Paul Diller; Ryo Inuzuka; Aleksander Kempny; Rafael Alonso-Gonzalez; Emmanouil Liodakis; Francesco Borgia; Christopher J Lockhart; Matina Prapa; Astrid E Lammers; Lorna Swan; Konstantinos Dimopoulos; Michael A Gatzoulis
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-23
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Sydney Street, London, UK; National Heart and Lung Institute, Imperial College School of Medicine, London, UK.
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