Findings from a study presented at the ACC.20 World Congress of Cardiology suggest that cardiologists are not adhering to the Bethesda Guidelines, which recommend restrictions for moderate and severe aortic stenosis (AS) patients participating in weight-lifting and organized sports.
To conduct this study, researchers surveyed 93 patients with AS and their cardiologists regarding weightlifting, organized sports participation, routine physical activity and exercise restriction. The participants were queried using the Pediatric Quality of Life Inventory (PedsQL) and the Pediatric Cardiac Quality of Life Inventory (PCQLI).
The results showed that patients with moderate AS were rarely restricted from participating in sports, but more frequently restricted from weightlifting. The researchers observed that patients with severe AS were not universally restricted from sports or weightlifting. Older patients were more likely to be restricted from sports, or patients with moderate as opposed to mild AS.
Although 26 subjects reported current sports restrictions, the results uncovered a discrepancy between physician and patient reported restriction status, as 12 patients reported to be sports restricted by the physician, only 8 self-identified as such; and 9 patients who self-identified as sports restricted had no such restriction from their physician. The results further showed that PCQLI scores for teens and young adults with AS were lower than a comparison group of patients with mild congenital heart disease, and PedsQL social functioning scores were lower for patients with exercise restrictions.
“There is discrepancy in physician and patient reported restriction status,” the authors wrote. “Patients with AS routinely adhere to restriction recommendations. Exercise restriction is associated with lower PCQLI and PedsQL social functioning scores.”
Mansfield L. Living with Congenital Aortic Stenosis: Exercise Restriction, Patterns of Adherence, And Quality of Life. Presented at the ACC.20 World Congress of Cardiology; March 28-30, Chicago, IL.