☆ 4.6 Review

Body composition in patients with Fontan physiology: a systematic review

EUROPEAN JOURNAL OF PEDIATRICS (2023)

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Article Cardiac & Cardiovascular Systems

Assessment of exercise capacity using field walking tests in patients after the Fontan procedure: A case-control study

Haluk Tekerlek et al.

Summary: Cardiorespiratory responses were assessed in Fontan patients using the 6-minute walk test (6MWT) and incremental shuttle walk test (ISWT). It was found that both tests showed significant changes in heart rate, oxygen saturation, dyspnea, and leg fatigue. The ISWT, which is safer and provides more pronounced exercise-induced responses, can be used as a field test to evaluate exercise capacity in Fontan patients.

HEART & LUNG (2023)

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Article Cardiac & Cardiovascular Systems

Exercise Prescription Enhances Maximal Oxygen Uptake and Anaerobic Threshold in Young Single Ventricle Patients with Fontan Circulation

Henri Pyykkonen et al.

Summary: Exercise prescription for pediatric Fontan patients can improve submaximal performance and workload tolerance over a 6-month period. This could be beneficial for enhancing daily activities and preventing chronic complications.

PEDIATRIC CARDIOLOGY (2022)

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Review Pediatrics

Exercise Intolerance, Benefits, and Prescription for People Living With a Fontan Circulation: The Fontan Fitness Intervention Trial (F-FIT)-Rationale and Design

Derek L. Tran et al.

Summary: Despite advancements in surgical techniques and medical care, people with a Fontan circulation still face long-term complications, indicating a need for non-invasive therapies to optimize circulation. Exercise intolerance is common among this population, but exercise training may be important for improving aerobic capacity and circulatory function in the setting of Fontan physiology. Further research is needed to fully understand the mechanisms behind these improvements and to determine optimal methods of exercise prescription.

FRONTIERS IN PEDIATRICS (2022)

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Article Cardiac & Cardiovascular Systems

Vitamin D, liver-related biomarkers, and distribution of fat and lean mass in young patients with Fontan circulation

Lena Hansson et al.

Summary: Vitamin D intake and serum levels were not found to be associated with body composition or liver biomarkers in young Fontan patients. However, these patients had lower lean mass and higher fat mass compared to controls. Male adolescents with Fontan circulation showed higher abdominal fat mass, which may raise metabolic risks in the future.

CARDIOLOGY IN THE YOUNG (2022)

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Review Cardiac & Cardiovascular Systems

Fontan Circulation Associated Organ Abnormalities Beyond the Heart, Lungs, Liver, and Gut: A Systematic Review

Evi Ritmeester et al.

Summary: In this systematic review, abnormalities in multiple organ systems for patients with a longstanding Fontan circulation were examined. The study found that these patients may experience abnormalities in the nervous system, pituitary, kidneys, and musculoskeletal system. These abnormalities may be related to Fontan physiology, cyanosis, iatrogenic factors, or lifestyle. Health care providers should be aware of the potential for hypothyroidism, visual or hearing deficits, and sleep disordered breathing in Fontan patients.

FRONTIERS IN CARDIOVASCULAR MEDICINE (2022)

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Article Cardiac & Cardiovascular Systems

Scaling Peak Oxygen Consumption for Body Size and Composition in People With a Fontan Circulation

Curtis A. Wadey et al.

Summary: The traditional method of ratio-scaling peak V?O2 to body mass is invalid in people with a Fontan circulation. However, scaling to measures of body composition (fat-free mass, lean mass, and appendicular lean mass) and using allometric techniques can produce size-independent expressions of peak V?O2 in this population.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2022)

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Article Cardiac & Cardiovascular Systems

Peak Work Rate Increases With Lower Extremity-Focused Exercise Training in Adolescents With Fontan Circulation

Catherine M. Avitabile et al.

Summary: Peak work rate and anaerobic activity increased with lower extremity-focused training in adolescents with Fontan circulation. However, leg lean mass did not improve. Additionally, training had no impact on physical activity questionnaire, quality of life scores, exercise cardiac magnetic resonance performance, and peripheral vascular function.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2022)

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Review Nutrition & Dietetics

Nutritional Management of Patients with Fontan Circulation: A Potential for Improved Outcomes from Birth to Adulthood

Letizia Baldini et al.

Summary: This review aims to analyze the role of an adequate form of nutritional support in patients with Fontan circulation throughout different stages of their lives and provide a practical approach to appropriate nutritional management.

NUTRIENTS (2022)

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Article Cardiac & Cardiovascular Systems

Body Mass Index Trajectory and Outcome Post Fontan Procedure

Emma Payne et al.

Summary: Poor infant growth in patients with a single ventricle is associated with increased long-term Fontan failure. Establishing BMI trajectory models in these patients helps determine optimal BMI targets for patient outcomes.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2022)

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Review Cardiac & Cardiovascular Systems

Physical exercise training in patients with a Fontan circulation: A systematic review

Linda E. Scheffers et al.

Summary: Exercise training in Fontan patients is likely safe and has positive effects on exercise capacity, cardiac function, and quality of life. Encouraging exercise training in Fontan patients is recommended, and further studies are needed to assess optimal training type, intensity, duration, and long-term effects.

EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY (2021)

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Review Medicine, General & Internal

Causal role of high body mass index in multiple chronic diseases: a systematic review and meta-analysis of Mendelian randomization studies

Susanna C. Larsson et al.

Summary: This study summarized evidence from Mendelian randomization studies, confirming a causal relationship between excess adiposity and a variety of chronic diseases. Genetically predicted higher BMI was associated with increased risk for several chronic diseases, while higher adult BMI was associated with decreased risk for certain diseases.

BMC MEDICINE (2021)

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Article Cardiac & Cardiovascular Systems

Impact of adiposity on clinical outcomes in people living with a Fontan circulation

Jacob Y. Cao et al.

Summary: The study found that increased adiposity in Fontan patients is associated with higher risk for adverse outcomes, while muscle mass is not related to adverse outcomes. The results suggest that lifestyle interventions targeting body composition optimization may be beneficial in reducing risk.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2021)

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Article Pediatrics

Deficits in the Functional Muscle-Bone Unit in Youths with Fontan Physiology

Sumeet S. Vaikunth et al.

Summary: Patients with Fontan physiology exhibit significant deficits in both cortical (hip, distal one-third radius) and trabecular (lumbar spine, femoral neck, ultradistal radius) bone mineral density (BMD). Lower leg lean mass is associated with lower BMD and may indicate inadequate skeletal muscle loading. Interventions to increase muscle mass may improve bone accrual.

JOURNAL OF PEDIATRICS (2021)

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Article Cardiac & Cardiovascular Systems

Role of Transient Elastography to Stage Fontan-Associated Liver Disease (FALD) in Adults with Single Ventricle Congenital Heart Disease Correction

Liliana Chemello et al.

Summary: Fontan-associated liver disease (FALD) is a developing clinical entity following successful Fontan operation for single ventricle congenital heart disease (CHD), characterized by liver cirrhosis and other hepatic complications. It results in increased morbidity and mortality, with no current consensus on staging methods. Testing liver stiffness (LS) through transient elastography (FibroScan) can effectively identify cases with advanced FALD and severe risk of complications.

JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE (2021)

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Article Cardiac & Cardiovascular Systems

Early characteristics of bone deficits in children with Fontan palliation

Kyriakie Sarafoglou et al.

CARDIOLOGY IN THE YOUNG (2020)

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Article Cardiac & Cardiovascular Systems

Body Composition in Young Adults Living With a Fontan Circulation: The Myopenic Profile

Derek Tran et al.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2020)

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Article Cardiac & Cardiovascular Systems

Impaired knee extension muscle strength in adolescents but not in children with Fontan circulation

Camilla Sandberg et al.

CARDIOLOGY IN THE YOUNG (2020)

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Review Cardiac & Cardiovascular Systems

Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity

Cole D. Bendor et al.

CARDIOVASCULAR DIABETOLOGY (2020)

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Positive pediatric exercise capacity trajectory predicts better adult Fontan physiology rationale for early establishment of exercise habits

Hideo Ohuchi et al.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2019)

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Overweight and obesity: an emerging problem in patients with congenital heart disease

Caroline Andonian et al.

CARDIOVASCULAR DIAGNOSIS AND THERAPY (2019)

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Leg lean mass correlates with exercise systemic output in young Fontan patients

Catherine M. Avitabile et al.

HEART (2018)

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Body composition, appetite-related hormones, adipocytokines, and heart failure in adult patients with congenital heart disease: A preliminary study

Yumi Shiina et al.

CONGENITAL HEART DISEASE (2018)

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Lower limb exercise generates pulsatile flow into the pulmonary vascular bed in the setting of the Fontan circulation

Rachael Cordina et al.

CARDIOLOGY IN THE YOUNG (2018)

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Clinical Outcomes in Adolescents and Adults After the Fontan Procedure

Mark Dennis et al.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2018)

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Article Endocrinology & Metabolism

Body composition by DXA

John A. Shepherd et al.

BONE (2017)

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Lean mass deficits, vitamin D status and exercise capacity in children and young adults after Fontan palliation

Catherine M. Avitabile et al.

HEART (2014)

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Article Geriatrics & Gerontology

Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Population-Based Cohort Study of Older Men

Janice L. Atkins et al.

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY (2014)

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Skeletal muscle abnormalities and exercise capacity in adults with a Fontan circulation

Rachael Cordina et al.

HEART (2013)

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Article Pharmacology & Pharmacy

Obesity, adiposity, and dyslipidemia: A consensus statement from the National Lipid Association

Harold E. Bays et al.

JOURNAL OF CLINICAL LIPIDOLOGY (2013)

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Measurement of Body Composition in Burned Children: Is There a Gold Standard?

Ludwik K. Branski et al.

JOURNAL OF PARENTERAL AND ENTERAL NUTRITION (2010)

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Article Radiology, Nuclear Medicine & Medical Imaging

Whole-body adipose tissue analysis: comparison of MRI, CT and dual energy X-ray absorptiometry

J. Kullberg et al.

BRITISH JOURNAL OF RADIOLOGY (2009)

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The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration

Alessandro Liberati et al.

BMJ-BRITISH MEDICAL JOURNAL (2009)

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The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies

Erik von Elm et al.

JOURNAL OF CLINICAL EPIDEMIOLOGY (2008)

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Is bioelectrical impedance accurate for use in large epidemiological studies?

Mahshid Dehghan et al.

NUTRITION JOURNAL (2008)

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Effects of exercise and respiration on blood flow in total cavopulmonary connection -: A real-time magnetic resonance flow study

VE Hjortdal et al.

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Obesity in adulthood and its consequences for, life expectancy: A life-table analysis

A Peeters et al.

ANNALS OF INTERNAL MEDICINE (2003)

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