Calf Muscle Oxygenation is Impaired and May Decline with Age in Young Patients with Total Cavopulmonary Connection

Bergdahl, Magne Sthen; Crenshaw, Albert G.; Hedlund, Eva Rylander; Sjöberg, Gunnar; Rydberg, Annika; Sandberg, Camilla

doi:10.1007/s00246-021-02743-6

Cited by 4 publications

(9 citation statements)

References 41 publications

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Section: Resultsmentioning

confidence: 99%

“…Six articles investigated the oxygenation of muscles in Fontan patients ( 26 , 61 , 74 – 76 ). Several studies evaluated muscle oxygenation with near-infrared spectroscopy ( 26 , 74 , 76 ). Muscle oxygenation is decreased at baseline, relating to reduced arterial oxygen saturation, but displays a normal response to exercise ( 26 ).…”

Section: Resultsmentioning

confidence: 99%

“…Several markers of muscle oxygenation during exercise—but not resting conditions- relate to overall exercise capacity ( 74 ). Muscle oxygenation defects may increase with age ( 76 ). Parameters of muscle oxygenation during exercise may be preserved in children (6–12 years), but impaired for adolescents (13–18 years) ( 76 ).…”

Section: Resultsmentioning

confidence: 99%

“…Muscle oxygenation defects may increase with age ( 76 ). Parameters of muscle oxygenation during exercise may be preserved in children (6–12 years), but impaired for adolescents (13–18 years) ( 76 ). Vandekerckhove et al did find impaired muscle oxygenation during exercise in patients aged 11.8 ± 2.8 years ( 26 ).…”

Section: Resultsmentioning

confidence: 99%

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

Ritmeester

Veger

Ven

et al. 2022

Front. Cardiovasc. Med.

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IntroductionPatients with a Fontan circulation are at risk for sequelae of Fontan physiology during follow-up. Fontan physiology affects all organ systems and an overview of end-organ damage is needed.MethodsWe performed a systematic review of abnormalities in multiple organ systems for patients with a longstanding Fontan circulation. We searched online databases for articles describing abnormalities in multiple organ systems. Cardio-pulmonary abnormalities, protein losing enteropathy, and Fontan associated liver disease have already extensively been described and were excluded from this systematic review.ResultsOur search returned 5,704 unique articles. After screening, we found 111 articles relating to multiple organ systems. We found abnormalities in, among others, the nervous system, pituitary, kidneys, and musculoskeletal system. Pituitary edema—relating to the unique pituitary vasculature- may affect the thyroid axis. Renal dysfunction is common. Creatinine based renal function estimates may be inappropriate due to myopenia. Both lean muscle mass and bone mineral density are decreased. These abnormalities in multiple organ systems may be related to Fontan physiology, cyanosis, iatrogenic factors, or lifestyle.ConclusionsHealth care providers should be vigilant for hypothyroidism, visual or hearing deficits, and sleep disordered breathing in Fontan patients. We recommend including cystatin C for assessment of renal function. This review may aid health care providers and guide future research.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232461, PROSPERO, identifier: CRD42021232461.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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

Ritmeester

Veger

Ven

et al. 2022

Front. Cardiovasc. Med.

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“…23 Pulmonary response. Studies reported significant reductions in peak 17,18 and maximal 21 minute ventilation, peak tidal volume, 17 percent-predicted oxygen uptake efficiency slope, 26,33,34 gas exchange threshold, 21 exercising or percentpredicted V E /VCO 2 slope, 18,21,26 diffusing capacity, 22 peripheral capillary oxygen saturation, 35 and anaerobic threshold. 17,23 Strömvall-Larsson et al 36 also found impaired pulmonary gas exchange with an alveolar-arterial O 2 partial pressure difference (P A-a O 2 ) during exercise of more than 2 standard deviations above the P A-a O 2 of healthy references, which, the authors hypothesized, arose partially from the presence of intracardiac and intrapulmonary right-to-left shunts.…”

Section: Cardiovascular Response and Exercise Capacitymentioning

confidence: 99%

Exercise Capacity and Training Programs in Paediatric Fontan Patients: A Systematic Review

Herrmann

Tierney

2022

CJC Pediatric and Congenital Heart Disease

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Lower bone strength in young patients with Fontan circulation compared to controls

Wikner,

Johansson,

Enocson

et al. 2024

Cardiol Young

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Objectives: Previous reports indicate bone deficits in patients with Fontan circulation. However, the consequences of these deficits on bone strength and when these changes occur are unclear. Aim: To compare the tibial bone strength-strain index between young patients (6–19 years) with Fontan circulation and age- and sex-matched controls, and to determine strength-strain-index in subgroups of children (6–12 years) and adolescents (13–19 years) versus controls. Method: The tibia was examined with peripheral quantitative CT. Based on the assessed data, bone strength-strain index was calculated in the lateral and anterior-posterior directions. Results: Twenty patients with Fontan and twenty controls (mean age 13.0 ± 4.4 years; 50% females) were examined. Patients had a lower strength-strain index in the lateral direction compared to controls (808.4 ± 416.8mm3 versus 1162.5 ± 552.1mm3, p = 0.043). Subgroup analyses showed no differences regarding strength-strain index in children (6–12 years) with Fontan circulation compared to controls. However, the adolescents (13–19 years) with Fontan circulation had lower strength-strain indexes in both the lateral and anterior-posterior directions compared to controls (1041.4 ± 299.8mm3 versus 1596.4 ± 239.6mm3, p < 0.001, and 771.7 ± 192.4mm3 versus 1084.9 ± 215.0mm3, p = 0.004). When adjusted for height, there were differences between patients (6–19 years) and controls in strength-strain indexes in both the lateral and anterior-posterior directions. In subgroup analyses, the results remained robust. Conclusion: Young patients (6–19 years) with Fontan circulation have a lower strength-strain index in the tibia compared to controls. Subgroup analyses show that this deficit is mainly driven by the differences in adolescents (13–19 years), which might suggest that bone strength decreases with age.

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Calf Muscle Oxygenation is Impaired and May Decline with Age in Young Patients with Total Cavopulmonary Connection

Cited by 4 publications

References 41 publications

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

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

Exercise Capacity and Training Programs in Paediatric Fontan Patients: A Systematic Review

Lower bone strength in young patients with Fontan circulation compared to controls

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