PMID- 29198937
OWN - NLM
STAT- MEDLINE
DCOM- 20181003
LR  - 20181004
IS  - 1875-2128 (Electronic)
IS  - 1875-2128 (Linking)
VI  - 111
IP  - 4
DP  - 2018 Apr
TI  - Cardiopulmonary exercise testing in the evaluation of liver disease in adults who 
      have had the Fontan operation.
PG  - 276-284
LID - S1875-2136(17)30224-3 [pii]
LID - 10.1016/j.acvd.2017.09.001 [doi]
AB  - BACKGROUND: Liver disease (LD) is a long-term complication in patients with a 
      single ventricle who have had the Fontan operation. A decline in cardiopulmonary 
      exercise testing (CPET) variables is associated with increased risk of 
      hospitalization, but its association with LD is unknown. AIM: To determine the 
      association between CPET variables and LD in adults who have had the Fontan 
      operation. METHODS: We retrospectively reviewed the medical records from two 
      tertiary institutions. RESULTS: We identified 114 adults (>/=18 years; mean 
      30.9+/-7.4 years) who had undergone the Fontan operation: 56% were women; 63% had 
      total cavopulmonary connection; 66% had New York Heart Association (NYHA) class I 
      status; 42% had arrhythmias; 22% had systemic right ventricle; and 35% had 
      ventricular dysfunction. Of 81 patients with liver-imaging data, 41% had LD (i.e. 
      imaging evidence of cirrhosis, with or without portal hypertension, splenomegaly 
      or varices). There were no differences in clinical or echocardiographic variables 
      between those with and without LD. Among the 58 patients with CPET data, mean 
      peak oxygen consumption (VO(2)) was 18.6+/-5.7mL/kg/min, per-cent-predicted peak 
      VO(2) was 53.9+/-15.5%, peak oxygen pulse was 9.3+/-2.9mL/beat and per-cent-predicted 
      peak oxygen pulse was 82.6+/-21.5%. Of the 44 patients with liver and CPET data, 
      each standard deviation decrease in per-cent-predicted peak VO(2) (16%) and 
      per-cent-predicted peak oxygen pulse (22%) was associated with a 2.3-fold 
      increase in the odds of LD, after adjusting for NYHA, institution and Fontan type 
      (P=0.04). Similarly, each standard deviation decrease in per-cent-predicted peak 
      VO(2) and oxygen pulse was associated with an estimated 5.9-year and 4.9-year 
      earlier onset of LD, respectively (P>0.05). CONCLUSIONS: Decline in 
      per-cent-predicted peak VO(2) and oxygen pulse was associated with increased odds 
      of LD in adults who had undergone the Fontan operation. Our study supports more 
      rapid hepatic evaluation among patients with abnormal or worsening CPET 
      variables.
CI  - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.
FAU - Agarwal, Anushree
AU  - Agarwal A
AD  - University of California San Francisco, San Francisco, CA, USA.
FAU - Cunnington, Colin
AU  - Cunnington C
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Sabanayagam, Aarthi
AU  - Sabanayagam A
AD  - University of California San Francisco, San Francisco, CA, USA.
FAU - Zier, Lucas
AU  - Zier L
AD  - University of California San Francisco, San Francisco, CA, USA.
FAU - McCulloch, Charles E
AU  - McCulloch CE
AD  - University of California San Francisco, San Francisco, CA, USA.
FAU - Harris, Ian S
AU  - Harris IS
AD  - University of California San Francisco, San Francisco, CA, USA.
FAU - Foster, Elyse
AU  - Foster E
AD  - University of California San Francisco, San Francisco, CA, USA.
FAU - Atkinson, Dougal
AU  - Atkinson D
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Bryan, Angela
AU  - Bryan A
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Jenkins, Petra
AU  - Jenkins P
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Dua, Jaspal
AU  - Dua J
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Parker, Michael J
AU  - Parker MJ
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Karunaratne, Devinda
AU  - Karunaratne D
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Moore, John A
AU  - Moore JA
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Meadows, Jeffrey
AU  - Meadows J
AD  - University of California San Francisco, San Francisco, CA, USA.
FAU - Clarke, Bernard
AU  - Clarke B
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Hoschtitzky, J Andreas
AU  - Hoschtitzky JA
AD  - Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, 
      Manchester, United Kingdom.
FAU - Mahadevan, Vaikom S
AU  - Mahadevan VS
AD  - University of California San Francisco, San Francisco, CA, USA; Manchester Royal 
      Infirmary, Central Manchester University Hospitals NHS Trust, Manchester, United 
      Kingdom. Electronic address: vaikom.mahadevan@ucsf.edu.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20171201
PL  - Netherlands
TA  - Arch Cardiovasc Dis
JT  - Archives of cardiovascular diseases
JID - 101465655
SB  - IM
MH  - Adult
MH  - Cardiorespiratory Fitness
MH  - Child
MH  - Child, Preschool
MH  - England
MH  - *Exercise Test
MH  - Female
MH  - Fontan Procedure/*adverse effects
MH  - Heart Defects, Congenital/physiopathology/*surgery
MH  - Hemodynamics
MH  - Humans
MH  - Liver Diseases/*diagnosis/etiology/physiopathology
MH  - Liver Function Tests
MH  - Male
MH  - Medical Records
MH  - Oxygen Consumption
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Factors
MH  - San Francisco
MH  - Tertiary Care Centers
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function
MH  - Young Adult
OTO - NOTNLM
OT  - Cardiopulmonary exercise test
OT  - Fontan
OT  - Hepatopathie
OT  - Liver disease
OT  - Operation de Fontan
OT  - Test d'effort cardiopulmonaire
EDAT- 2017/12/05 06:00
MHDA- 2018/10/04 06:00
CRDT- 2017/12/05 06:00
PHST- 2017/01/16 00:00 [received]
PHST- 2017/09/08 00:00 [revised]
PHST- 2017/09/13 00:00 [accepted]
PHST- 2017/12/05 06:00 [pubmed]
PHST- 2018/10/04 06:00 [medline]
PHST- 2017/12/05 06:00 [entrez]
AID - S1875-2136(17)30224-3 [pii]
AID - 10.1016/j.acvd.2017.09.001 [doi]
PST - ppublish
SO  - Arch Cardiovasc Dis. 2018 Apr;111(4):276-284. doi: 10.1016/j.acvd.2017.09.001. 
      Epub 2017 Dec 1.