Résumé
Objective: we aimed to evaluate the evolution in cardiopulmonary fitness (VO2max), measured by cardio-pulmonary exercise test (CPET), of children with CHD compared to matched healthy controls and identify predictors of VO2max change in this specific population. Method: this longitudinal multicentre cohort study was carried out from 2010 to 2020. Starting to an initial study comparing children with CHD to controls, we included CHD patients from this cohort who had a second CPET at least 1 year after the first as part of their follow-up.Results: we included 936 children, 296 in the CHD group and 640 controls. Mean time between baseline and final CPET was 4.4±1.7 years. After matching on age and gender and adjustment on age and BMI, the mean VO2max predicts difference between CHD and matched controls was 10.6±1.0% at baseline CPET and 19.1±1.3% at final CPET. In the CHD group, the percentage of subjects with VO2max <80% of VO2max predicts were significantly higher in the final compared to baseline CPET (51.4% vs 20.3%; P<0.01). The mean annual decrease was significantly worse in the CHD group than control (-1.88±0.19% of VO2max predicts/year vs. -0.44±0.27% of VO2max predicts/year, P<0.01, respectively). In multivariate analyse, the predictors of VO2max annual decrease were male gender, a high initial VO2max, a high BMI, the number of cardiac surgical procedures ≥ 2.Conclusion: the annual decline in VO2max is significantly greater in patients with CHD. This study highlights the importance of monitoring patients with CHD in adolescence and promoting cardiovascular rehabilitation.