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Self-estimated physical functioning poorly predicts actual exercise capacity in adolescents and adults with congenital heart disease.

AIMS
The aim of this study is to compare self-reported health-related quality-of-life (HRQoL) with the objective of exercise performance in patients with congenital heart disease (CHD) according to diagnosis.


METHODS AND RESULTS
564 patients (255 females, 14-73 years) with various CHD (62 shunt, 66 left heart obstruction, 33 PS/PR, 47 Ebstein, 96 Fallot, 98 TGA after atrial switch, 38 other TGA, 31 Fontan, 32 palliated/native cyanotic, 61 others) and a group of 53 healthy controls (18 females, 14-57 years) completed a QoL questionnaire (SF-36) and performed a symptom-limited cardiopulmonary exercise test. Despite several limitations at exercise (P = 1.30 x 10(-33)), patients only reported reductions in HRQoL concerning physical functioning (P = 4.41 x 10(-15)) and general health (P = 6.17 x 10(-5)) and not psychosocial aspects. This could be confirmed in all diagnostic subgroups. Correlation to peak oxygen uptake was found in physical functioning (r = 0.435, P = 1.72 x 10(-27)) and general health (r = 0.275, P = 3.79 x 10(-11)). However, there was severe overestimation of physical functioning in most patients when compared with actual exercise test results.


CONCLUSION
Patients with CHD rate their HRQoL impaired only in physical functioning and general health and not in any psychosocial aspect. Self-estimated physical functioning poorly predicts actual exercise capacity.