{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:57:30Z","timestamp":1765839450985,"version":"3.48.0"},"reference-count":38,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014688","name":"Region Uppsala","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014688","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish National Stroke Association","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,10,26]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adults with congenital heart disease (ACHD) are a heterogeneous group with a large variation in the severity of lesions and symptoms. This population has rapidly grown in recent years due to improved surgical and medical treatments. Sedentary time and physical activity (PA) and health among individuals classified with single lesions, for example, shunt defects such as atrial and ventricular septal defects, and patent foramen ovale (PFO) with stroke are less studied. The present study describes the study protocol and examines associations between sedentary time, PA, circulating biomarkers in the blood (heart and muscles) and heart failure. Results have the potential to supply the healthcare system with information if further action to promote cardiovascular health in ACHD is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A cross-sectional design will be used with data from the local heart register, Swedish Registry for Congenital Heart Disease in Uppsala, Sweden. Individuals \u226518 years of age with simple congenital heart disease, according to the definition atrial septal defect, ventricle septal defect or PFO as the cause of stroke, will be included.<\/jats:p>\n                    <jats:p>Outcome measures: Self-reported questionnaire: demographic characteristics, education, the prevalence of diabetes, smoking, ethnicity, self-reported level of sitting time and leisure-time PA\/exercise, everyday activities, commuting and degree of symptoms associated with exertion. Blood analyses: blood lipids (total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol, apolipoprotein A1 and B), creatinine, cystatin-C (eGFR), creatine kinase, myoglobin, high-sensitivity troponin, brain natriuretic peptide, C-reactive protein and glycated haemoglobin. Quantitative methods will be used for statistical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The Swedish Ethical Review Authority has approved the study (registration numbers 2022-06525-01 and 2023-02082-02). Results will be disseminated in peer-reviewed journals, research meetings, conferences and possibly patient organisations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087907","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T01:06:24Z","timestamp":1732151184000},"page":"e087907","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association between sedentary time, physical activity, biochemical markers in the blood (heart and muscles) and heart failure in adults with congenital heart disease: a study protocol of a cross-sectional cohort study in Sweden (the ACHD trial protocol)"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1508-1435","authenticated-orcid":false,"given":"Birgit Maria","family":"Vahlberg","sequence":"first","affiliation":[{"name":"Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2704-4065","authenticated-orcid":false,"given":"Christer","family":"Jansson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Physiotherapy, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torbj\u00f6rn","family":"\u00c5kerfeldt","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Christersson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"doi-asserted-by":"publisher","key":"2025121514534582000_14.11.e087907.1","DOI":"10.1093\/eurheartj\/ehaa554"},{"doi-asserted-by":"publisher","key":"2025121514534582000_14.11.e087907.2","DOI":"10.1093\/eurheartj\/ehaa605"},{"key":"2025121514534582000_14.11.e087907.3","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.pcad.2020.03.002","article-title":"Recommendations for exercise in adolescents and adults with congenital heart disease","volume":"63","author":"Tran","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"key":"2025121514534582000_14.11.e087907.4","doi-asserted-by":"crossref","first-page":"229","DOI":"10.5853\/jos.2015.17.3.229","article-title":"Patent Foramen Ovale and Stroke\u2013Current Status","volume":"17","author":"Bang","year":"2015","journal-title":"J Stroke"},{"doi-asserted-by":"publisher","key":"2025121514534582000_14.11.e087907.5","DOI":"10.1056\/NEJMoa1707404"},{"doi-asserted-by":"publisher","key":"2025121514534582000_14.11.e087907.6","DOI":"10.1056\/NEJMoa1705915"},{"doi-asserted-by":"publisher","key":"2025121514534582000_14.11.e087907.7","DOI":"10.1016\/j.jacc.2015.12.023"},{"key":"2025121514534582000_14.11.e087907.8","first-page":"547","article-title":"Habitual Physical Activity in Adults With Congenital Heart Disease Compared With Age- and Sex-Matched Controls","volume":"32","author":"Sandberg","year":"2016","journal-title":"Can J Cardiol"},{"key":"2025121514534582000_14.11.e087907.9","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","article-title":"Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association","volume":"147","author":"Tsao","year":"2023","journal-title":"Circulation"},{"doi-asserted-by":"publisher","key":"2025121514534582000_14.11.e087907.10","DOI":"10.1093\/eurheartj\/eht433"},{"key":"2025121514534582000_14.11.e087907.11","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1177\/2047487320924912","article-title":"Standardization and quality improvement of secondary prevention through cardiovascular rehabilitation programmes in Europe: The avenue towards EAPC accreditation programme: A position statement of the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology (EAPC)","volume":"28","author":"Abreu","year":"2021","journal-title":"Eur J Prev Cardiol"},{"key":"2025121514534582000_14.11.e087907.12","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1016\/j.amjcard.2018.06.056","article-title":"Physical Activity-Related Drivers of Perceived Health Status in Adults With Congenital Heart Disease","volume":"122","author":"Ko","year":"2018","journal-title":"Am J Cardiol"},{"key":"2025121514534582000_14.11.e087907.13","first-page":"126","article-title":"Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research","volume":"100","author":"Caspersen","year":"1985","journal-title":"Pub Health Rep"},{"unstructured":"Jansson E , Wennberg P , Anderssen SA , et al . 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