Exercise Performance in Adolescents With Fontan Physiology (from the Pediatric Heart Network Fontan Public Data Set)
Section snippets
Methods
The Pediatric Heart Network (PHN) was established in 2001 by the National Heart, Lung and Blood Institute to facilitate multisite clinical research for children with congenital heart disease. Their Fontan observational study enrolled 546 children 6 to 18 years old who had undergone Fontan surgery.12 We performed a retrospective study using the PHN Fontan dataset released for public use (downloaded from the PHN website, www.pediatricheartnetwork.org),13 with approval from the University of
Results
Demographics and clinical characteristics for subjects with Fontan physiology who achieved peak exercise and AT with comparisons between females and males are shown in Table 1. There were no demographic or clinical differences between males and females with Fontan physiology. The only sex-based difference between the groups reaching AT was a higher rate of paced cardiac rhythm in females (13% vs 7%, p = 0.047).
Table 2 shows the exercise parameters at peak exercise broken down by sex and 2-year
Discussion
Using a large, prospectively collected dataset of exercise performance parameters for children and adolescents with Fontan physiology, we were able to generate normative values for the most clinically relevant exercise parameters for the population of children and adolescents with Fontan physiology. In contrast to increases in peak VO2 through adolescence in the general population, our data demonstrate a plateau or decreases in peak VO2 through adolescence for patients with Fontan physiology.
Author contributions
Michael D. Seckeler: Conceptualization, Formal analysis, Methodology, Writing – original draft Brent J. Barber: Methodology, Writing – review & editing Jamie N. Colombo: Conceptualization, Methodology, Writing – review & editing Alyssa M. Bernardi: Conceptualization, Writing – review & editing Andrew W. Hoyer: Writing – review & editing Jennifer G. Andrews: Methodology, Writing – review & editing Scott E. Klewer: Writing – review & editing.
Disclosures
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Cited by (2)
FUELing Improved Treatment for Patients with Fontan Physiology
2024, American Journal of CardiologyCardiac Concerns in the Pediatric Athlete
2022, Clinics in Sports MedicineCitation Excerpt :With the absence of a subpulmonary ventricle, patients with Fontan physiology are known to have a markedly impaired response to physical activity and low oxygen consumption at peak exercise and anaerobic threshold. Chronic elevation of central venous pressure leads to decreased preload and low cardiac output.66–69 Despite a global reduction in exercise capacity, each patient with Fontan physiology is different, making thorough cardiovascular evaluation of the utmost importance before participation in sports.