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Exercise restriction is not associated with increasing body mass index over time in patients with anomalous aortic origin of the coronary arteries

Published online by Cambridge University Press:  02 May 2017

James M. Meza ,
Matthew D. Elias ,
Travis J. Wilder ,
James E. O’Brien ,
Richard W. Kim ,
Constantine Mavroudis ,
William G. Williams ,
Julie Brothers ,
Meryl S. Cohen  and
Brian W. McCrindle
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James M. Meza
Affiliation:
John W. Kirklin/David Ashburn Fellow, Congenital Heart Surgeons’ Society Data Center, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
Matthew D. Elias
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Travis J. Wilder
Affiliation:
Department of Surgery, University of California San Diego School of Medicine, San Diego, California, United States of America
James E. O’Brien
Affiliation:
Division of Cardiovascular Surgery, Children’s Mercy Hospital, Kansas City, Missouri, United States of America
Richard W. Kim
Affiliation:
Division of Cardiothoracic Surgery, Children’s Hospital of Los Angeles, Los Angeles, California, United States of America
Constantine Mavroudis
Affiliation:
Department of Congenital Heart Surgery, Florida Hospital for Children, Orlando, Florida, United States of America
William G. Williams
Affiliation:
Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, CA
Julie Brothers
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Meryl S. Cohen
Affiliation:
Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
Brian W. McCrindle*
Affiliation:
Division of Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
*
Correspondence to: B. W. McCrindle, MD, MPH, Division of Cardiology, The Hospital for Sick Children, 555 University Avenue, Room 4432, Toronto, ON, Canada, M5G 1X8. Tel: +1 416 813 7609; Fax: +1 416 813 7547; E-mail: [email protected]
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Abstract

Anomalous aortic origin of the coronary arteries is associated with exercise-induced ischaemia, leading some physicians to restrict exercise in patients with this condition. We sought to determine whether exercise restriction was associated with increasing body mass index over time. From 1998 to 2015, 440 patients ⩽30 years old were enrolled into an inception cohort. Exercise-restriction status was documented in 143 patients. Using linear mixed model repeated-measures regression, factors associated with increasing body mass index z-score over time, including exercise restriction and surgical intervention as time-varying covariates, were investigated. The 143 patients attended 558 clinic visits for which exercise-restriction status was recorded. The mean number of clinic visits per patient was 4, and the median duration of follow-up was 1.7 years (interquartile range (IQR) 0.5–4.4). The median age at first clinic visit was 10.3 years (IQR 7.1–13.9), and 71% (101/143) were males. All patients were alive at their most recent follow-up. At the first clinic visit, 54% (78/143) were exercise restricted, and restriction status changed in 34% (48/143) during follow-up. The median baseline body mass index z-score was 0.2 (IQR 0.3–0.9). In repeated-measures analysis, neither time-related exercise restriction nor its interaction with time was associated with increasing body mass index z-score. Surgical intervention and its interaction with time were associated with decreasing body mass index z-score. Although exercise restriction was not associated with increasing body mass index over time, surgical intervention was associated with decreasing body mass index z-score over time in patients with anomalous aortic origin of the coronary arteries.

Keywords

Anomalous coronary arteriesexercise restrictionbody mass indexrepeated-measures analysis
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 8 , October 2017 , pp. 1538 - 1544
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Copyright
© Cambridge University Press 2017 

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Footnotes

*

James M. Meza, Matthew Elias, Brian W. McCrindle, and Meryl Cohen contributed equally to this manuscript.

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