Longitudinal development of obesity in the post-Fontan population

Wellnitz, Kari; Harris, I.; Sapru, Anil; Fineman, Jeffrey R.; Radman, Monique

doi:10.1038/ejcn.2015.68

Cited by 32 publications

(30 citation statements)

References 15 publications

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“…Although our unmatched data and results from previous smaller studies suggest that obesity prevalence is lower in certain ACHD populations, several recent studies have found that individuals with complex CHD have an increased prevalence of obesity after the Fontan operation. [16][17][18] We found similar obesity rates between ACHD and control groups by using our greedy matching algorithm. This discrepancy highlights the importance of accounting for age and sex when defining these risk factors in the ACHD population.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome in Adults With Congenital Heart Disease

Deen

Krieger

Slee

et al. 2016

JAHA

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BackgroundMetabolic syndrome increases risk for atherosclerotic coronary artery disease, and its prevalence increases with increasing age and body mass index. Adults with congenital heart disease (ACHD) are now living longer and accruing coronary artery disease risk factors. However, the prevalence of metabolic syndrome in ACHD patients is unknown.Methods and ResultsWe conducted a retrospective cohort study of ACHD patients at our center to quantify the prevalence of metabolic syndrome in an ACHD population. Using case‐control matching, we constructed a comparable control group from a population‐based sample of 150 104 adults. International Diabetes Federation criteria were used to define metabolic syndrome. We used logistic regression to compare the risk of metabolic syndrome across the resulting cohorts, which were composed of 448 ACHD patients and 448 controls matched by age and sex. Mean age of both groups was 32.4±11.3 years, and 51.3% were female. Obesity was present in 16.1% of the ACHD patients and 16.7% of the controls. Metabolic syndrome was more common in ACHD patients than in controls (15.0% versus 7.4%; odds ratio 1.82, 95% CI 1.25–2.65).ConclusionsOur data suggest that metabolic syndrome is more common among adults with congenital heart disease than in the general population. Thus, patients with congenital heart disease should be screened for metabolic syndrome and risk factors mitigated where possible to prevent atherosclerotic coronary artery disease. Preventive cardiology should be included during routine ACHD care.

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Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome in Adults With Congenital Heart Disease

Deen

Krieger

Slee

et al. 2016

JAHA

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“…While some studies have demonstrated lower rates of obesity in patients with single ventricles, obesity was present in 11% of pediatric and 17% of adult Fontan patients 55)56)57). Several recent studies have shown that patients post Fontan procedure have an increased prevalence of obesity 58)59)60). Association of obesity such as diastolic dysfunction and ventricular hypertrophy may complicate the management of ACHD patients who are already at risk for ventricular dysfunction, arrhythmias, and heart failure 61)62).…”

Section: Risk Factors For Coronary Artery Disease and Metabolic Syndrmentioning

confidence: 99%

Metabolic Syndrome in Adult Congenital Heart Disease

Niwa

2019

Korean Circ J

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In adult congenital heart disease (ACHD), residua and sequellae after initial repair develop late complications such as cardiac failure, arrhythmias, thrombosis, aortopathy, pulmonary hypertension and others. Acquired lesions with aging such as hypertension, diabetes mellitus, obesity can be negative influence on original cardiovascular disease (CVD). Also, atherosclerosis may pose an additional health problem to ACHD when they grow older and reach the age at which atherosclerosis becomes clinically relevant. In spite of the theoretical risk of atherosclerosis in ACHD due to above mentioned factors, cyanotic ACHDs even after repair are noted to have minimal incidence of coronary artery disease (CAD). Acyanotic ACHD has similar prevalence of CAD as the general population. However, even in cyanotic ACHD, CAD can develop when they have several risk factors for CAD. The prevalence of risk factor is similar between ACHD and the general population. Risk of premature atherosclerotic CVD in ACHD is based, 3 principal mechanisms: lesions with coronary artery abnormalities, obstructive lesions of left ventricle and aorta such as coarctation of the aorta and aortopathy. Coronary artery abnormalities are directly affected or altered surgically, such as arterial switch in transposition patients, may confer greater risk for premature atherosclerotic CAD. Metabolic syndrome is more common among ACHD than in the general population, and possibly increases the incidence of atherosclerotic CAD even in ACHD in future. Thus, ACHD should be screened for metabolic syndrome and eliminating risk factors for atherosclerotic CAD.

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“…As survival of children with serious illnesses such as cancer and heart disease has improved, lifestyle issues such as fitness, healthful eating and obesity have become long‐term concerns for them . Childhood cancer survivors (CCS) now face the same lifestyle issues as the general population as the habits they establish in their youth carry over into adulthood.…”

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confidence: 99%