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Perceived Health Mediates Effects of Physical Activity on Quality of Life in Patients With a Fontan Circulation.

Journal article
Authors Christina E Holbein
Gruschen R Veldtman
Philip Moons
Adrienne H Kovacs
Koen Luyckx
Silke Apers
Shanti Chidambarathanu
Alexandra Soufi
Katrine Eriksen
Jamie L Jackson
Junko Enomoto
Susan M Fernandes
Bengt Johansson
Luis Alday
Mikael Dellborg
Malin Berghammer
Samuel Menahem
Maryanne Caruana
Shelby Kutty
Andrew S Mackie
Corina Thomet
Werner Budts
Kamila White
Maayke A Sluman
Edward Callus
Stephen C Cook
Paul Khairy
Ari Cedars
Published in The American journal of cardiology
Volume 124
Issue 1
Pages 144-150
ISSN 1879-1913
Publication year 2019
Published at Institute of Health and Care Sciences
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 144-150
Language en
Subject categories Clinical Medicine


Patients with a Fontan circulation are at risk of a sedentary lifestyle. Given the direct relationship between physical activity and health, promotion of physical activity has the potential to improve outcomes, including quality of life (QOL). This study aimed to describe self-reported physical activity levels in adult Fontan patients and examine associations between physical activity, perceived health status and QOL. The sample consisted of 177 Fontan patients (Mage = 27.5 ± 7.6 years, 52% male) who reported their physical activity, perceived health status, and QOL as part of the cross-sectional Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study. Descriptive statistics and univariate analyses of variance with planned contrasts were computed to describe physical activity characteristics. Mediation analyses tested whether perceived health status variables mediated the association between physical activity and QOL. Forty-six percent of patients were sedentary while only 40% met international physical activity guidelines. Higher physical activity was associated with younger age, lower NYHA class, higher perceived general health, and greater QOL. Patients who commuted by walking and engaged in sports reported better perceived health and QOL. Mediation analyses revealed that perceived general health but not NYHA functional class mediated the association between physical activity and QOL (αβ = 0.22, 95% confidence interval = 0.04 to 0.49). In conclusion, Fontan patients likely benefit from regular physical activity, having both higher perceived general health and functional capacity; greater perceived health status may contribute to enhanced QOL. In conclusion, these data support the pivotal role of regular physical activity for Fontan patients.

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