Children with heart disease had significant differences in all the domains of frailty, which included weakness, slowness, height and weight, exhaustion and physical activity levels compared with children without the condition, according to a presentation at Cardiology 2018.
“We always knew subjectively that these kids will probably be slower, probably be weak, probably be tired more quickly, but we were surprised with how slower they were, how quickly they got tired and how much less activity they would do as compared to other kids,” 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 and pulmonary hypertension. Patients were age- and sex-matched to healthy controls (n = 22; mean age, 12 years; 59% boys).
Frailty phenotype was measured using methods developed for children such as 6-minute walk test, hand grip strength, physical activity questionnaire and body measurements.
“Kids with all these chronic heart diseases like Fontan, heart failure or pulmonary hypertension, we all know they’re sick,” Panchangam said in an interview. “We don’t have a great tool that can assess for global frailty. That’s why we were interested in checking this tool to see first if we can even make some adjustments in the tool that was described … and adapt it to the pediatric population.”
Compared with the control group, children with significant cardiac disease 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 cardiac disease also had lower height (P < .001) and weight (P < .01) vs. the control group. Physical activity, as reported from questionnaires, was lower in the significant cardiac disease group compared with the control group (P < .001).
“Our next step is to look at the clinical data maybe 1 or 2 years down the line and see how their performance 2 or 3 years ago correlates with their clinical evaluation today,” Panchangam told Cardiology Today. “[If] we find out that these particular parameters predict worse outcomes, that would be the next step, and then trying to expand this particular tool into other cardiac conditions or even noncardiac conditions.” – by Darlene Dobkowski
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.