Abstract 12649: Cardiovascular Exercise Reduces Anxiety Symptoms in Adults With Congenital Heart Disease
Background: Adult congenital heart disease (ACHD) patients (pts) have high rates of untreated depression and anxiety disorders. We evaluated the association between self-reported depression and anxiety symptoms and cardiopulmonary exercise.
Methods: From 2009 to 2013, 193 ACHD pts (46% male) completed clinical questionnaires including data regarding symptoms of depression and anxiety, and frequency of cardiopulmonary exercise. Data were collected by retrospective review.
Results: Mean age was 31 + 10 years. Disease severity was classified as: mild (20%), moderate (48%), and severe (32%). Nineteen percent of pts reported being depressed often and 26% were nervous or anxious. There was no association between age, gender or severity of disease and depression or anxiety symptoms.
Exercise frequency was classified as none (27%), low (<3x/month, 6%), occasional (<2x/week, 8%) or frequent (> 2x/week, 58%). There was no significant association between severity of disease and frequency of exercise. Fewer pts who exercised reported anxiety symptoms compared to those who did not exercise (21% vs 35%, p=0.04). When adjusted for age, gender and severity of illness, pts who exercised frequently were half as likely to report symptoms of anxiety (OR 0.46; 95% CI 0.23 to 0.91) as those who never exercised.
Exercise stress test data was available in 85 pts. Frequent exercisers had higher peak VO2 (28.6 + 7.8 versus 24.9 + 6.8 ml/kg/min, p=0.03), predicted VO2 (81.4% + 19.6 vs 66.9% + 14.9, p=0.001), and maximal METS (8.3 + 2.2 vs 7.0 + 2, p=0.01). Frequent exercisers also had lower resting heart rates (72 + 13bpm vs 79 + 12 bpm, p=0.02). Disease severity in pts who exercised frequently was: mild (23%), moderate (54%), and severe (23%).
Fourteen percent of pts were on antidepressant/antianxiety (AD/AA) medications (meds); 56% of this subgroup still reported anxiety symptoms. There was a greater percentage of non-exercisers vs frequent exercisers in those with continued symptoms (50% vs 14%).
Conclusion: Regular cardiopulmonary exercise by ACHD pts is associated with decreased self-reported anxiety symptoms and improved exercise capacity. Cardiopulmonary exercise may be an adjunct mode of treatment for anxiety disorder, but further investigation is needed.
Author Disclosures: M. Khan: None. M. Smith: None. V. Freedenberg: None. N. Klein: None. A.S. John: None.
- © 2014 by American Heart Association, Inc.