Assessing Cardiovascular Health in Paediatric Hypertrophic Cardiomyopathy Using the CANHEART Health Index

Victoria Srbely MSc , Aamir Jeewa MD , Tara Pidborochynski MSc , Samuel Lemaire-Paquette MSc , Michael Khoury MD , Chentel Cunningham RN , Santokh Dhillon MD , Nassiba Alami Laroussi MD , Laurence Vaujois MD , Frederic Dallaire MD, PhD , Daryl Schantz MD , Kathryn Armstrong MD , Wadi Mawad MD , Timothy Bradley MD , Jennifer Conway MD, MSc
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Abstract

Background

Paediatric hypertrophic cardiomyopathy (HCM) is associated with sudden cardiac death, often resulting in restriction of strenuous physical activity. High levels of inactivity and a rise in youth obesity may increase risk of poor cardiovascular (CV) health in these patients. We aim to compare the CV disease risk profile of paediatric patients with HCM to Canadian youth.

Methods

Patients with HCM (10-19 years) were recruited from 10 paediatric cardiac centres in Canada. The CV disease risk profile was determined using the Healthy Hearts School Program questionnaire and Cardiovascular Health in Ambulatory Care Research Team (CANHEART) health index. Poisson regressions were used to assess associations between the CV disease risk profile of paediatric patients with HCM and the overall CANHEART health score.

Results

A total of 56 subjects were enrolled (71% male, median age: 15.5 years [interquartile range: 13.8-16.8], median body mass index: 23.3 [interquartile range: 19.5-27.7]). Results of the CANHEART health index revealed that 89% of participants with HCM never tried smoking, 52% had a healthy body mass index, 39% consumed ≥5 fruits/vegetables per day, and 50% engaged in ≥60 minutes of walking or 20 minutes of running/jogging per day. When CANHEART intermediate and poor health index scores were combined, similar proportions were obtained for each group (HCM 82.1% vs Canadian youth 83.4%; P = 0.724).

Conclusions

Many paediatric patients with HCM in Canada have intermediate or poor CV health as determined by the CANHEART health score, with high rates of obesity and low physical activity levels driving these trends. Interventions should be developed to promote positive CV health behaviours among patients with HCM.
使用 CANHEART 健康指数评估小儿肥厚型心肌病患者的心血管健康状况
背景小儿肥厚型心肌病(HCM)与心脏性猝死有关,通常会导致剧烈运动受限。高水平的不运动和青少年肥胖的增加可能会增加这些患者心血管(CV)健康不良的风险。我们的目的是比较 HCM 儿科患者与加拿大青少年的心血管疾病风险概况。方法从加拿大的 10 个儿科心脏中心招募 HCM 患者(10-19 岁)。采用健康心脏学校计划调查问卷和非卧床护理心血管健康研究小组(CANHEART)健康指数确定心血管疾病风险概况。结果 共有 56 名受试者(71% 为男性,中位年龄:15.5 岁[四分位间范围:13.8-16.8],中位体重指数:23.3[四分位间范围:23.3])参加了研究:23.3[四分位数间距:19.5-27.7])。CANHEART 健康指数结果显示,89% 的 HCM 患者从未尝试过吸烟,52% 的患者拥有健康的体重指数,39% 的患者每天食用≥5 个水果/蔬菜,50% 的患者每天步行≥60 分钟或跑步/慢跑≥20 分钟。结论根据 CANHEART 健康评分,加拿大许多患有 HCM 的儿科患者的 CV 健康状况处于中等或较差水平,肥胖率高和体力活动水平低是造成这种趋势的原因。应制定干预措施,在 HCM 患者中推广积极的心血管健康行为。
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