Somatic growth in 94 single ventricle children – comparing systemic right and left ventricle patients

Hessel, Trine Witzner; Greisen, Gorm; Idorn, Lars; Reimers, Jørgen

doi:10.1111/apa.12032

Cited by 11 publications

(13 citation statements)

References 22 publications

(39 reference statements)

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“…4 A recent study by Hessel and colleagues investigating somatic growth in 94 SV patients up to 11 years of age demonstrated that patients with a dominant RV had lower weight for age. 26 Our data were not conclusive but tended to support the notion that SV patients with non-LV dominance, that is, RV dominance or indeterminate ventricular morphology, had shorter stature at the time of Fontan conversion.…”

Section: Commentcontrasting

confidence: 86%

Growth and Obesity Among Older Single Ventricle Patients Presenting for Fontan Conversion

Freud

Webster

Costello

et al. 2015

World J Pediatr Congenit Heart Surg

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Section: Commentcontrasting

confidence: 86%

Growth and Obesity Among Older Single Ventricle Patients Presenting for Fontan Conversion

Freud

Webster

Costello

et al. 2015

World J Pediatr Congenit Heart Surg

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“…A total of 95 citations were identified, of which 36 publications were potentially relevant and retrieved as full text. Nineteen reports 9 , 15 , 16 , 17 , 18 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 of an equal number of individual studies fulfilled our eligibility criteria (Figure 1 ). Characteristics of each study and their participants are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…A total of 17 studies 9,[15][16][17][18][22][23][24][25][27][28][29][31][32][33][34][35] including 1419 participants reported on weight z scores. The available data points are plotted in 2).…”

Section: Weight Z Scoresmentioning

confidence: 99%

“…9,17,31,34,35 • Central shunt and pulmonary artery reconstruction (reflecting hypoplasia or distortion of the pulmonary arteries) and RV dominance are associated with lower z scores for weight after the Fontan procedure. 16,25 • Need for heart failure treatment after Fontan completion is associated with decreased late somatic development. 18 • Although not seen in the majority of patients, oversizing, bending or compression of the Fontan conduit may lead to thrombosis and protein loss, and thus to growth retardation.…”

Section: Problem Solutionmentioning

confidence: 99%

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Somatic growth in single ventricle patients: A systematic review and meta‐analysis

et al. 2022

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Aim:To map somatic growth patterns throughout Fontan palliation and summarise evidence on its key modifiers.Methods: Databases were searched for relevant articles published from January 2000 to December 2021. Height and weight z scores at each time point (birth, Glenn procedure, Fontan procedure and >5 years after Fontan completion) were pooled using a random effects meta-analysis. A random effects meta-regression model was fitted to model the trend in z scores over time.Results: Nineteen studies fulfilled eligibility criteria, yielding a total of 2006 participants. The z scores for height and weight were markedly reduced from birth to the interstage period, but recovered by about 50% following the Glenn procedure. At >10 years after the Fontan procedure, the z scores for weight seemed to normalise despite persistent lower height, resulting in increased body mass index. The review revealed a number of modifiers of somatic growth, including aggressive nutritional management, timing of Glenn/Fontan, prompt resolution of complications and obesity prevention programmes in adolescence and adulthood. | 187Van DEN EYNDE et al. Conclusion:This review mapped the somatic growth of single ventricle patients and summarised key modifiers that may be amendable to improvement. These data provide guidance on strategies to further optimise somatic growth in this population and may serve as a benchmark for clinical follow-up. K E Y W O R D Scongenital heart disease, development, Fontan procedure, functionally univentricular hearts, growth Key notes• In single ventricle patients, the z scores for height and weight were markedly reduced from birth to interstage period, but recovered by about 50% following the Glenn procedure.• At >10 years after the Fontan procedure, the z scores for weight seemed to normalise despite persistent lower height.

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“… 6 – 15 Most studies evaluated the effect of surgery on growth. 7 , 8 , 9 , 10 , 11 , 15 Despite the relevant role of surgery in the anthropometric recovery of children with congenital heart disease, in relation to other factors, a variable percentage of them does not present improvements in anthropometric indicators, which is usually referred to as growth catch-up. One of these is the epidemiological factor, which has been little studied as a predictor of nutritional recovery in patients with congenital heart disease.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for insufficient weight and height gain in children with congenital heart disease followed up at a nutrition outpatient clinic

Talassi

Konstantyner

Miranda

et al. 2022

Rev. paul. pediatr.

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Objective: To describe weight and height evolution and to identify risk factors for insufficient anthropometric growth in children with congenital heart disease. Methods: Historical cohort study including 131 children with congenital heart disease, followed up at a nutrition outpatient clinic. The anthropometric indices over time (initial score, after 12 and 24 months of follow-up) were analyzed using generalized estimating equations. The outcome was ‘insufficient weight-height gain’, defined as an increase of ≤0.5 in the z-score of weight-for-age (W/A), height-for-age (H/A) or body mass index-for-age (BMI/A) after 12 months of follow-up. Multiple logistic regression models were applied to identify risk and confounding factors. Results: The z-scores of W/A (p<0.001) and BMI/A (p<0.001) improved after 12 months, as well as the three indexes after 24 months (p<0.001). At the end of this period, 55.7% of the patients did not achieve an increase of >0.5 in the Z score of W/A; 77.1%, of H/A; and 45.8%, of BMI/A. A follow-up of less than five appointments was associated with insufficient gain in W/A (OR 7.78; 95%CI 3.04–19.88), H/A (OR 10.79; 95%CI 2.22–52.45) and BMI/A (OR 2.54; 95%CI 1.12–5.75). Not having undergone cardiac surgery and being aged ≥12 months were factors associated with insufficient W/A gain (OR 3.95; 95%CI 1.38–11.29/OR 3.60; 95%CI 1.33–9.72) and BMI/A (OR 2.81; 95%CI 1.08–7.28/OR 3.39; 95%CI 1.34–8.56). Low income was associated with insufficient H/A gain (OR 4.11; 95%CI 1.25–13.46). Conclusions: Being aged less than or 12 months, the lowest number of appointments, absence of surgical treatment and low family income were risk factors for insufficient weight and height gain in children with congenital heart disease.

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Somatic growth in 94 single ventricle children – comparing systemic right and left ventricle patients

Abstract: After the Glenn anastomosis single ventricle children with a systemic left ventricle have better weight gain compared with children with a systemic right ventricle.

Cited by 11 publications

References 22 publications

Growth and Obesity Among Older Single Ventricle Patients Presenting for Fontan Conversion

Growth and Obesity Among Older Single Ventricle Patients Presenting for Fontan Conversion

Somatic growth in single ventricle patients: A systematic review and meta‐analysis

Risk factors for insufficient weight and height gain in children with congenital heart disease followed up at a nutrition outpatient clinic

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