Abstract P313: Sport Participation Associated With Fewer Anxiety Symptoms in Adult Congenital Heart Disease

Introduction: Physical activity (PA) has well-known benefits for mental health, which is closely related to clinical outcomes in patients with heart disease; however, little is known about the relationship between PA and anxiety. In this study, we examined their association in a large international cohort of adult congenital heart disease (ACHD) patients.

Hypothesis: We hypothesize that different PA types would have differential impact on anxiety symptoms.

Methods: We conducted a cross-sectional assessment of data derived from the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart Disease - International Study. This study enrolled 4,028 ACHD patients from 24 centers in 15 countries. Anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS). Participants reported whether they were regular active commuters (either walk or cycle to work/school) and/or regular sport participants (either recreational or competitive). To assess the relationship between PA and anxiety, we constructed ordinal logistic mixed models, treating country as a random effect. We built an optimally-adjusted model via stepwise selection, which considered all variables having significant relations with anxiety in bivariate analyses and missing at a rate of < 5%.

Results: Of 3,893 patients (mean age of 35 ± 13) who completed the HADS, 53% were female; 27% reported elevated anxiety symptoms (i.e., HADS ≥ 8). No significant relationship was found between active commute and anxiety symptoms in bivariate analysis while sport participation was associated with a 40% lower risk of elevated anxiety. The benefit of sport participation on anxiety remained, even after accounting for relevant demographic and clinical variables (adjusted OR=0.769; 95% CI 0.654 - 0.906; p = 0.002) (Table 1).

Conclusion: Sport participation is associated with fewer symptoms of anxiety. In conclusion, individualized sport-related exercise prescriptions may reduce anxiety symptoms in cardiac patients.