Meeting News

Pilot study measures frailty in children with significant heart conditions

Chaitanya Panchangam

“We always suspected that children with significant heart conditions would perform worse than healthy children, but we were surprised at how significant the differences were between the two groups,” Chaitanya Panchangam, MBBS, cardiology fellow at Children’s Mercy Hospital in Kansas City, Missouri, told Cardiology Today.

Researchers analyzed data from 34 children (mean age, 12 years; 62% boys) with at least one of the following: HF, status-post Fontan surgery and pulmonary hypertension. Patients were age- and sex-matched to healthy controls (n = 22; mean age, 12 years; 59% boys).

Frailty phenotype, as described in the elderly, was measured using developmentally appropriate methods for children such as 6-minute walk test, hand grip strength, Peds Multidimensional fatigue scale to assess exhaustion, body composition and physical activity assessed using activity recall questionnaires and an accelerometer.

“While we know that children with significant heart conditions such as Fontan, heart failure or pulmonary hypertension have significant morbidity and lower quality of life,” Panchangam said in an interview. “We don’t have an easily administered and validated score that can assess for global infirmity. Therefore, we were interested to see if the frailty score, which is typically used in the elderly, could be adapted to the pediatric population.”

Compared with the control group, children with significant heart conditions scored lower for 6-minute walk test, hand grip strength in both their dominant and nondominant hands and on the multidimensional fatigue scale (P < .001 for all).

Children with significant heart conditions also had lower height (P < .001) and weight (P < .01) vs. the control group. However, BMI, mid-upper arm circumference and triceps skin fold thickness were not different. Physical activity, as reported from self-reported questionnaires as well as objective assessment using accelerometer (wGT3X-BT, ActiGraph), was lower in the children with significant heart conditions as compared with controls (P < .001).

“Our next step is to conduct a longitudinal study of frailty in a larger cohort of children with heart conditions to assess if their score predicts adverse clinical outcomes,” Panchangam told Cardiology Today. – by Darlene Dobkowski

Reference:

Panchangam C, et al. Abstract 63. Presented at: Cardiology: 21st Annual Update on Pediatric and Congenital Cardiovascular Disease; Feb. 21-25, 2018; Scottsdale, Ariz.

Disclosure: Panchangam reports no relevant financial disclosures.

Reference:

Panchangam C, et al. Abstract 63. Presented at: Cardiology: 21st Annual Update on Pediatric and Congenital Cardiovascular Disease; Feb. 21-25, 2018; Scottsdale, Ariz.

Disclosure: Panchangam reports no relevant financial disclosures.

Chaitanya Panchangam

Children with significant heart conditions had significant differences in all the domains of frailty, which included weakness, slowness, height and weight, exhaustion and physical activity levels when compared with healthy controls, according to a presentation at Cardiology 2018.

“We always suspected that children with significant heart conditions would perform worse than healthy children, but we were surprised at how significant the differences were between the two groups,” Chaitanya Panchangam, MBBS, cardiology fellow at Children’s Mercy Hospital in Kansas City, Missouri, told Cardiology Today.

Researchers analyzed data from 34 children (mean age, 12 years; 62% boys) with at least one of the following: HF, status-post Fontan surgery and pulmonary hypertension. Patients were age- and sex-matched to healthy controls (n = 22; mean age, 12 years; 59% boys).

Frailty phenotype, as described in the elderly, was measured using developmentally appropriate methods for children such as 6-minute walk test, hand grip strength, Peds Multidimensional fatigue scale to assess exhaustion, body composition and physical activity assessed using activity recall questionnaires and an accelerometer.

“While we know that children with significant heart conditions such as Fontan, heart failure or pulmonary hypertension have significant morbidity and lower quality of life,” Panchangam said in an interview. “We don’t have an easily administered and validated score that can assess for global infirmity. Therefore, we were interested to see if the frailty score, which is typically used in the elderly, could be adapted to the pediatric population.”

Compared with the control group, children with significant heart conditions scored lower for 6-minute walk test, hand grip strength in both their dominant and nondominant hands and on the multidimensional fatigue scale (P < .001 for all).

Children with significant heart conditions also had lower height (P < .001) and weight (P < .01) vs. the control group. However, BMI, mid-upper arm circumference and triceps skin fold thickness were not different. Physical activity, as reported from self-reported questionnaires as well as objective assessment using accelerometer (wGT3X-BT, ActiGraph), was lower in the children with significant heart conditions as compared with controls (P < .001).

“Our next step is to conduct a longitudinal study of frailty in a larger cohort of children with heart conditions to assess if their score predicts adverse clinical outcomes,” Panchangam told Cardiology Today. – by Darlene Dobkowski

Reference:

Panchangam C, et al. Abstract 63. Presented at: Cardiology: 21st Annual Update on Pediatric and Congenital Cardiovascular Disease; Feb. 21-25, 2018; Scottsdale, Ariz.

Disclosure: Panchangam reports no relevant financial disclosures.

Reference:

Panchangam C, et al. Abstract 63. Presented at: Cardiology: 21st Annual Update on Pediatric and Congenital Cardiovascular Disease; Feb. 21-25, 2018; Scottsdale, Ariz.

Disclosure: Panchangam reports no relevant financial disclosures.