The effects of physical activity in children with hypoplastic left heart syndrome after complete palliation with Fontan procedure

BACKGROUND: Hypoplastic left heart syndrome (HLHS) describes a heterogeneous group of pathologies characterized by underdevelopment of the structures of the left side of the heart. Several studies have investigated the possible beneficial effects of physical activity in these patients, however this topic is not yet fully clarified. The aim of this study was to evaluate the effects of exercise on NT-proBNP in patients with HLHS after complete palliation with Fontan procedure. METHODS: We enrolled 14 (9 male) patients with HLHS after Fontan surgery. Each patient underwent a cardiological examination, echocardiogram and blood tests. Physical activity was assessed by submitting the International Physical Activity Questionnaire (IPAQ) to the children together with their parents. Based on the score obtained, the patients were divided into two groups. In group I, children who carried out regular daily physical activity. In group II, on the other hand, the children who, according to the questionnaire scores, led a sedentary life were considered RESULTS: Among the echocardiographic parameters in the study, fractional area change (RVFAC) was considered to evaluate the function of the systemic right ventricle. Statistical analysis did not show a significant difference in right ventricle function between the two groups: RVFAC 36.29±4.8% vs. 35.14±5.3% (P>0.05) in group I and group II respectively. We then assessed whether there was a difference between the NT-proBNP levels between the two groups and the data analysis showed a significant difference between group I and group II, 65.98±20.03 ng/L vs 102.95±23.65 ng/L (P<0.01) respectively. CONCLUSIONS: Our data show a reduction of NT-proBNP levels in the group of children who perform physical activity compared to the group of sedentary children. More studies will be needed to confirm these data.