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Article Abstract
Background: Exercise capacity is reduced in patients with a Fontan circulation compared to their healthy peers secondary to altered haemodynamics of the Fontan circulation. Cardiopulmonary exercise testing is routinely used in Fontan patients to assess their cardiopulmonary response to exercise and help guide management decisions, however their results are routinely compared to normative data derived from healthy individuals.
Method: Using data available from the Pediatric Heart Network, we performed a retrospective study to derive Fontan-specific normative values in a subgroup of well-functioning adolescent patients. We utilised results from the Congenital Heart Adolescent and Teenager (CHAT) Questionnaire to classify patients into well-functioning and lower-functioning groups.
Results: We generated Fontan-specific regression equations in adolescent male and females for normative values of peak oxygen consumption (VO), maximal workload and VO at anaerobic threshold.
Conclusion: We propose that Fontan-specific normative values are a more useful comparison than healthy normative data due to the known circulatory limitations of the Fontan circulation and will assist in management decision and prognostication.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11658341 | PMC |
| http://dx.doi.org/10.1016/j.ijcchd.2024.100514 | DOI Listing |
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Deriving fontan-specific normative exercise data from well-functioning adolescents.
Int J Cardiol Congenit Heart Dis
September 2024
The University of Sydney, Sydney, New South Wales 2006, Australia.
Background: Exercise capacity is reduced in patients with a Fontan circulation compared to their healthy peers secondary to altered haemodynamics of the Fontan circulation. Cardiopulmonary exercise testing is routinely used in Fontan patients to assess their cardiopulmonary response to exercise and help guide management decisions, however their results are routinely compared to normative data derived from healthy individuals.
Method: Using data available from the Pediatric Heart Network, we performed a retrospective study to derive Fontan-specific normative values in a subgroup of well-functioning adolescent patients.
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Article Synopsis
- - The study utilized data from the FORCE registry to analyze cardiac magnetic resonance (CMR) metrics in healthier Fontan patients, aiming to create Fontan-specific z-scores that consider different ventricular morphologies.
- - The "healthier" cohort consisted of 885 patients, primarily children, who were assessed for ventricular size and function against those with adverse outcomes, revealing that those with left ventricle morphology had better metrics.
- - Comparisons showed adults had lower blood flow in the ascending aorta than children, and patients with adverse outcomes tended to have higher heart volumes and mass, which suggests a link between ventricular morphology and patient prognosis post-Fontan surgery.