Exercise capacity in a cohort of children with congenital heart disease

In patients with congenital heart disease (CHD), reduced exercise capacity can be a predictor for late complications and may be used to guide interventions. Yet, the interpretation of exercise capacity is challenged by changes in body composition during growth. Our aim was to create an overview of disease-specific exercise capacity in children with CHD. We performed a multicentre retrospective study of exercise capacity of CHD patients, aged 6–18 years, tested between January 2001 and October 2018. Sex-specific distribution graphs were made using the LMS method and height to relate to body size. We included all CHD with N > 50, including severe defects (e.g., univentricular heart, tetralogy of Fallot) and “simple” lesions as ventricular septum defect and atrial septum defect. We included 1383 tests of 1208 individual patients for analysis. The peak oxygen uptake (VO(2)peak, 37.3 ml/min/kg (25th–75th percentile 31.3–43.8)) varied between specific defects; patients with univentricular hearts had lower VO(2peak) compared with other CHD. All groups had lower VO(2peak) compared to healthy Dutch children. Males had higher VO(2peak), W(peak) and O(2)pulse(peak) than females. Sex- and disease-specific distribution graphs for VO(2peak), W(peak) and O2pulse(peak) showed increase in variation with increase in height. Conclusion: Disease-specific distribution graphs for exercise capacity in children with CHD from a large multicentre cohort demonstrated varying degrees of reduced VO(2peak) and W(peak). The distribution graphs can be used in the structured follow-up of patients with CHD to predict outcome and identify patients at risk. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-022-04648-9.