PMID- 37433405
OWN - NLM
STAT- MEDLINE
DCOM- 20230814
LR  - 20230916
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 388
DP  - 2023 Oct 1
TI  - Clinical and invasively-measured predictors of high exercise capacity in Fontan 
      patients.
PG  - 131166
LID - S0167-5273(23)00973-7 [pii]
LID - 10.1016/j.ijcard.2023.131166 [doi]
AB  - INTRODUCTION: Fontan patients have variable exercise capacity. Contemporary 
      understanding as to which factors predict high tolerance is limited. METHODS: 
      Records from the Ahmanson/University of California, Los Angeles Adult Congenital 
      Heart Disease Center were reviewed for adult Fontan patients who underwent CPET. 
      Patients were considered "high performers" if their maximum oxygen uptake (VO(2) 
      max/kg)-predicted was greater than 80%. Cross-sectional clinical, hemodynamic, 
      and liver biopsy data was gathered. High-performers were compared to control 
      patients across these parameters via associations and regression. RESULTS: A 
      total of 195 adult patients were included; 27 patients were considered "high 
      performers". They had lower body mass indices (BMI, p < 0.001), mean Fontan 
      pressures (p = 0.026), and cardiac outputs (p = 0.013). High performers also had 
      higher activity levels (p < 0.001), serum albumin levels (p = 0.003), 
      non-invasive and invasive systemic arterial oxygen saturations (p < 0.001 and 
      p = 0.004), lower New York Heart Association (NYHA) heart failure class 
      (p = 0.002), and were younger at Fontan completion (p = 0.011). High performers 
      had less severe liver fibrosis (p = 0.015). Simple regression found Fontan 
      pressure, non-invasive O(2) saturation, albumin level, activity level, age at 
      Fontan surgery, NYHA class, and BMI to predict significant changes in VO(2) 
      max/kg %-predicted. These associations persisted in multiple regression for 
      non-invasive O(2) saturation, NYHA class II, activity level, and BMI. 
      CONCLUSIONS: Thin Fontan patients who exercise more had better exercise capacity, 
      Fontan hemodynamic profiles, and less liver fibrosis.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Ponder, Reid
AU  - Ponder R
AD  - Department of Medicine, Tufts University School of Medicine, Boston, MA, United 
      States of America; Division of Cardiology, Ahmanson/UCLA Adult Congenital Heart 
      Disease Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United 
      States of America. Electronic address: Reid.Ponder@tufts.edu.
FAU - Chez, Luke
AU  - Chez L
AD  - Division of Pediatric Cardiology, David Geffen School of Medicine at UCLA, Los 
      Angeles, CA, United States of America.
FAU - Rosenthal, Carl J
AU  - Rosenthal CJ
AD  - University of California-Los Angeles, Los Angeles, CA, United States of America.
FAU - Bravo, Katia
AU  - Bravo K
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United 
      States of America.
FAU - Lluri, Gentian
AU  - Lluri G
AD  - Division of Cardiology, Ahmanson/UCLA Adult Congenital Heart Disease Center, 
      David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of 
      America.
FAU - Reardon, Leigh
AU  - Reardon L
AD  - Division of Pediatric Cardiology, David Geffen School of Medicine at UCLA, Los 
      Angeles, CA, United States of America; Division of Cardiology, Ahmanson/UCLA 
      Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA, 
      Los Angeles, CA, United States of America.
FAU - Lin, Jeannette
AU  - Lin J
AD  - Division of Cardiology, Ahmanson/UCLA Adult Congenital Heart Disease Center, 
      David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of 
      America.
FAU - Levi, Daniel S
AU  - Levi DS
AD  - Division of Pediatric Cardiology, David Geffen School of Medicine at UCLA, Los 
      Angeles, CA, United States of America.
FAU - Aboulhosn, Jamil A
AU  - Aboulhosn JA
AD  - Division of Cardiology, Ahmanson/UCLA Adult Congenital Heart Disease Center, 
      David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of 
      America.
LA  - eng
PT  - Journal Article
DEP - 20230709
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Humans
MH  - Adult
MH  - *Heart Defects, Congenital/diagnosis/surgery
MH  - Oxygen Consumption
MH  - Exercise Tolerance
MH  - Cross-Sectional Studies
MH  - Oxygen
MH  - *Fontan Procedure
MH  - Liver Cirrhosis
MH  - Exercise Test
OTO - NOTNLM
OT  - BMI
OT  - CPET
OT  - Exercise
OT  - Fontan
OT  - Outcomes
EDAT- 2023/07/12 01:07
MHDA- 2023/08/14 06:43
CRDT- 2023/07/11 19:16
PHST- 2023/05/14 00:00 [received]
PHST- 2023/07/04 00:00 [revised]
PHST- 2023/07/06 00:00 [accepted]
PHST- 2023/08/14 06:43 [medline]
PHST- 2023/07/12 01:07 [pubmed]
PHST- 2023/07/11 19:16 [entrez]
AID - S0167-5273(23)00973-7 [pii]
AID - 10.1016/j.ijcard.2023.131166 [doi]
PST - ppublish
SO  - Int J Cardiol. 2023 Oct 1;388:131166. doi: 10.1016/j.ijcard.2023.131166. Epub 
      2023 Jul 9.