선천성 심장병 수술을 받은 소아청소년에서 비만 유병률이 일반 아동보다 현저히 높다는 장기 추적 연구 결과가 발표됐다.
국제학술지 《Cardiology in the Young》 2026년호에 게재된 이 연구는 2004년부터 2020년까지 수술적 교정을 받은 CHD 환자 240명을 대상으로 체중 상태를 추적 분석했다. 연구 결과 과체중 비율은 36.2%, 비만 비율은 20.8%로 나타났다. 이는 오리건 주 일반 아동 평균 비만율인 13.7%보다 통계적으로 유의하게 높은 수치다.
심장 유형별로 분석하면 대동맥 축착 환자에서 비만율이 가장 높았다. 대동맥 축착은 혈관 협착으로 인해 심장이 더 강하게 펌프질해야 하는 구조적 결함으로, 수술 후에도 혈압 조절 문제와 활동 제한이 지속되는 경우가 많다.
연구진은 운동 제한과 초기 체중 증가에 대한 경각심 부족을 주요 비만 위험 요인으로 지목했다. CHD 아동들은 심장 수술 후 의료진 또는 부모의 판단으로 신체 활동을 과도하게 제한받는 경향이 있으며, 이는 장기적으로 에너지 불균형과 비만으로 이어질 수 있다.
연구진은 "CHD 수술 환자에서 비만은 단순한 체중 문제를 넘어 심혈관 예후에 직접 영향을 미친다"며 "수술 이후부터 체계적인 체중 모니터링과 맞춤형 운동 프로그램이 필요하다"고 강조했다.
CHD 소아청소년의 운동 처방은 심장 상태와 수술 유형에 따라 개별화돼야 한다. 무조건적인 활동 제한보다는 심장전문의와 운동 전문가가 협력해 안전한 수준의 신체활동 목표를 설정하는 것이 권장된다.
※ 출처: Cardiology in the Young, 2026. PMID: 41958292
Children and adolescents who have undergone surgical repair for congenital heart disease (CHD) face a significantly elevated risk of obesity compared to the general pediatric population, according to a new longitudinal study published in Cardiology in the Young in 2026.
Researchers tracked 240 patients who received surgical correction for various forms of CHD between 2004 and 2020. At follow-up, 36.2% of participants were classified as overweight and 20.8% as obese — a combined excess weight prevalence exceeding general pediatric benchmarks. The obesity rate of 20.8% was significantly higher than the statewide average of 13.7% for Oregon children (p<0.01).
Among the CHD subtypes examined, patients with coarctation of the aorta showed the highest obesity rates. Coarctation involves a narrowing of the aorta that forces the heart to work harder to maintain adequate blood flow throughout the body. Even after surgical repair, these patients often continue to face challenges related to blood pressure regulation, exercise tolerance, and activity restrictions — all of which can contribute to weight gain over time.
The study identified two primary risk factors driving obesity in the CHD surgical population: physical activity restrictions imposed after cardiac surgery and insufficient early emphasis on weight management. CHD children are frequently advised — sometimes over-conservatively — to limit physical exertion, particularly in the months following surgery. While caution is warranted in the acute post-operative period, prolonged or excessive restriction of physical activity can disrupt normal energy balance and set the stage for obesity.
Obesity in CHD patients is not merely a cosmetic concern. Excess body weight places additional demands on an already-stressed cardiovascular system, potentially accelerating disease progression, worsening heart function, and increasing the risk of adverse outcomes including arrhythmias and heart failure.
The findings underscore the need for a proactive, coordinated approach to weight management in pediatric CHD populations. Cardiologists, sports medicine specialists, and dietitians should collaborate to develop individualized physical activity plans that are both safe and sufficient to support healthy body composition. Rather than blanket exercise restrictions, tailored physical activity prescriptions based on each patient's cardiac anatomy and functional capacity are recommended.
Parents and caregivers of children with repaired CHD are encouraged to discuss weight monitoring and activity goals with their care team starting early after surgery, rather than waiting until excess weight becomes apparent. Early intervention is likely to be far more effective than efforts to reverse established obesity.
Source: Cardiology in the Young, 2026. PMID: 41958292
