S. D. Haas, Department of Pediatric Cardiology, Emma Children’s Hospital, Amsterdam, The Netherlands.
A. E. van der Hulst, C. Adel, A. Malekzadeh, N. A. Blom, M. Konigs, et al.

Trends Cardiovasc Med 2025

Congenital heart disease (CHD) is the most common birth defect, and despite advancements in medical care, children with surgically corrected CHD often experience reduced cardiorespiratory fitness, which is associated with negative long-term health outcomes. This meta-analysis aimed to quantify peak oxygen consumption (V̇O2peak) impairments in children with surgically corrected CHD, examine isolated diagnosis-specific impairments, and explore the relationship between clinical variables and cardiorespiratory fitness. A total of 45 studies encompassing 2,536 children with CHD and 3,108 healthy controls were included in the meta-analysis, revealing that children with CHD had significantly lower V̇O2peak (standardized mean difference = 1.13, 95%CI 0.98-1.28), with those having univentricular hearts being most affected (standardized mean difference = 1.61, 95%CI 1.34-1.87). Reduced saturation during exercise, chronotropic impairment and early onset of anaerobic threshold are likely to play a role in this impairment.