Diastolic Dysfunction With Preserved Ejection Fraction After the Fontan Procedure

Background Heart failure phenotyping in single-ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved eject...

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Published in:Journal of the American Heart Association Vol. 11; no. 2; p. e024095
Main Authors: Chowdhury, Shahryar M., Graham, Eric M., Taylor, Carolyn L., Savage, Andrew, McHugh, Kimberly E., Gaydos, Stephanie, Nutting, Arni C., Zile, Michael R., Atz, Andrew M.
Format: Journal Article
Language:English
Published: England John Wiley and Sons Inc 18.01.2022
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ISSN:2047-9980, 2047-9980
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Abstract Background Heart failure phenotyping in single-ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross-sectional Study database. EF was considered abnormal if <50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e'/end-diastolic volume) was >90th percentile (≥0.26 mL ). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO . Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), <0.01. DD patients had lower predicted peak VO compared with controls (52% [20] versus 67% [23], <0.01). Physical FSS was lower in DD (45±13) and SD (44±13) compared with controls (50±7), <0.01. Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.
AbstractList Background Heart failure phenotyping in single-ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross-sectional Study database. EF was considered abnormal if <50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e'/end-diastolic volume) was >90th percentile (≥0.26 mL ). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO . Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), <0.01. DD patients had lower predicted peak VO compared with controls (52% [20] versus 67% [23], <0.01). Physical FSS was lower in DD (45±13) and SD (44±13) compared with controls (50±7), <0.01. Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.
Background Heart failure phenotyping in single-ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross-sectional Study database. EF was considered abnormal if <50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e'/end-diastolic volume) was >90th percentile (≥0.26 mL-1). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO2. Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), P<0.01. DD patients had lower predicted peak VO2 compared with controls (52% [20] versus 67% [23], P<0.01). Physical FSS was lower in DD (45±13) and SD (44±13) compared with controls (50±7), P<0.01. Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.Background Heart failure phenotyping in single-ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross-sectional Study database. EF was considered abnormal if <50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e'/end-diastolic volume) was >90th percentile (≥0.26 mL-1). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO2. Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), P<0.01. DD patients had lower predicted peak VO2 compared with controls (52% [20] versus 67% [23], P<0.01). Physical FSS was lower in DD (45±13) and SD (44±13) compared with controls (50±7), P<0.01. Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.
Background Heart failure phenotyping in single‐ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The objective of this study was to identify Fontan patients with abnormal diastolic function, who are high risk for heart failure with preserved ejection fraction (HFpEF), and characterize their cardiac mechanics, exercise function, and functional health status. Methods and Results Data were obtained from the Pediatric Heart Network Fontan Cross‐sectional Study database. EF was considered abnormal if <50%. Diastolic function was defined as abnormal if the diastolic pressure:volume quotient (lateral E:e’/end‐diastolic volume) was >90th percentile (≥0.26 mL‐1). Patients were divided into: controls=normal EF and diastolic function; systolic dysfunction (SD) = abnormal EF with normal diastolic function; diastolic dysfunction (DD) = normal EF with abnormal diastolic pressure:volume quotient. Exercise function was quantified as percent predicted peak VO2. Physical Functioning Summary Score (FSS) was reported from the Child Health Questionnaire. A total of 239 patients were included, 177 (74%) control, 36 (15%) SD, and 26 (11%) DD. Median age was 12.2 (5.4) years. Arterial elastance, a measure of arterial stiffness, was higher in DD (3.6±1.1 mm Hg/mL) compared with controls (2.5±0.8 mm Hg/mL), P<0.01. DD patients had lower predicted peak VO2 compared with controls (52% [20] versus 67% [23], P<0.01). Physical FSS was lower in DD (45±13) and SD (44±13) compared with controls (50±7), P<0.01. Conclusions Fontan patients with abnormal diastolic function and normal EF have decreased exercise tolerance, decreased functional health status, and elevated arterial stiffness. Identification of patients at high risk for HFpEF is feasible and should be considered when evaluating Fontan patients.
Author Chowdhury, Shahryar M.
Zile, Michael R.
Taylor, Carolyn L.
McHugh, Kimberly E.
Graham, Eric M.
Nutting, Arni C.
Atz, Andrew M.
Savage, Andrew
Gaydos, Stephanie
AuthorAffiliation 1 Division of Cardiology Department of Pediatrics Medical University of South Carolina Charleston SC
2 Division of Cardiology Department of Medicine Medical University of South Carolina Charleston SC
AuthorAffiliation_xml – name: 2 Division of Cardiology Department of Medicine Medical University of South Carolina Charleston SC
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/35023347$$D View this record in MEDLINE/PubMed
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Cites_doi 10.1016/j.echo.2016.02.016
10.1016/j.ijcard.2018.04.089
10.1161/CIRCULATIONAHA.119.044352
10.1016/j.jacc.2006.05.051
10.1136/hrt.2004.051789
10.1161/CIRCULATIONAHA.113.006191
10.1152/ajpheart.00184.2014
10.1111/chd.12358
10.1161/01.CIR.0000048123.22359.A0
10.1161/JAHA.117.006000
10.1161/CIRCULATIONAHA.106.659763
10.1017/S1047951113000632
10.1007/s10554-018-1440-z
10.1161/01.CIR.0000018621.96210.72
10.1007/s00467-005-2122-3
10.1139/h94-003
10.1007/s10741-020-09932-0
10.1016/j.jacc.2008.01.074
10.1017/S1047951119001859
10.1016/j.echo.2017.11.010
10.1016/j.ahj.2006.02.009
10.3389/fphys.2019.00638
10.1111/chd.12368
10.1007/s00392-015-0863-y
10.1016/j.amjcard.2009.03.058
10.1016/j.ijcard.2017.04.073
10.1007/s00246-014-0888-4
10.1161/hc3801.096326
10.1186/s12872-017-0705-0
10.1007/s10741-019-09904-z
10.1001/jamacardio.2019.5459
10.1161/CIRCULATIONAHA.117.029058
10.1016/j.echo.2016.07.016
10.1007/s00246-018-1819-6
10.1136/heartjnl-2015-309042
10.1161/CIRCIMAGING.112.000175
10.1016/j.jacc.2017.03.582
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Keywords heart failure
diastolic function
single ventricle
Fontan
Language English
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For Sources of Funding and Disclosures, see page 7.
An abstract describing the results of this study was presented at the American College of Cardiology Scientific Sessions, March 28–30, 2020.
Supplemental Material for this article is available at https://www.ahajournals.org/doi/suppl/10.1161/JAHA.121.024095
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References e_1_3_1_21_2
e_1_3_1_22_2
e_1_3_1_23_2
e_1_3_1_24_2
e_1_3_1_8_2
e_1_3_1_7_2
e_1_3_1_9_2
e_1_3_1_20_2
e_1_3_1_4_2
e_1_3_1_29_2
e_1_3_1_3_2
e_1_3_1_6_2
e_1_3_1_5_2
e_1_3_1_25_2
e_1_3_1_26_2
e_1_3_1_2_2
e_1_3_1_27_2
e_1_3_1_28_2
e_1_3_1_32_2
e_1_3_1_33_2
e_1_3_1_34_2
e_1_3_1_35_2
e_1_3_1_13_2
e_1_3_1_12_2
e_1_3_1_11_2
e_1_3_1_30_2
e_1_3_1_10_2
e_1_3_1_31_2
e_1_3_1_17_2
e_1_3_1_16_2
e_1_3_1_15_2
e_1_3_1_14_2
e_1_3_1_36_2
e_1_3_1_37_2
e_1_3_1_19_2
e_1_3_1_38_2
e_1_3_1_18_2
References_xml – ident: e_1_3_1_13_2
  doi: 10.1016/j.echo.2016.02.016
– ident: e_1_3_1_32_2
  doi: 10.1016/j.ijcard.2018.04.089
– ident: e_1_3_1_38_2
  doi: 10.1161/CIRCULATIONAHA.119.044352
– ident: e_1_3_1_21_2
  doi: 10.1016/j.jacc.2006.05.051
– ident: e_1_3_1_2_2
  doi: 10.1136/hrt.2004.051789
– ident: e_1_3_1_37_2
  doi: 10.1161/CIRCULATIONAHA.113.006191
– ident: e_1_3_1_22_2
  doi: 10.1152/ajpheart.00184.2014
– ident: e_1_3_1_24_2
  doi: 10.1111/chd.12358
– ident: e_1_3_1_26_2
  doi: 10.1161/01.CIR.0000048123.22359.A0
– ident: e_1_3_1_29_2
  doi: 10.1161/JAHA.117.006000
– ident: e_1_3_1_27_2
  doi: 10.1161/CIRCULATIONAHA.106.659763
– ident: e_1_3_1_15_2
  doi: 10.1017/S1047951113000632
– ident: e_1_3_1_20_2
  doi: 10.1007/s10554-018-1440-z
– ident: e_1_3_1_25_2
  doi: 10.1161/01.CIR.0000018621.96210.72
– ident: e_1_3_1_16_2
  doi: 10.1007/s00467-005-2122-3
– ident: e_1_3_1_14_2
  doi: 10.1139/h94-003
– ident: e_1_3_1_3_2
  doi: 10.1007/s10741-020-09932-0
– ident: e_1_3_1_11_2
  doi: 10.1016/j.jacc.2008.01.074
– ident: e_1_3_1_7_2
  doi: 10.1017/S1047951119001859
– ident: e_1_3_1_8_2
  doi: 10.1016/j.echo.2017.11.010
– ident: e_1_3_1_10_2
  doi: 10.1016/j.ahj.2006.02.009
– ident: e_1_3_1_19_2
  doi: 10.3389/fphys.2019.00638
– ident: e_1_3_1_4_2
  doi: 10.1111/chd.12368
– ident: e_1_3_1_9_2
  doi: 10.1007/s00392-015-0863-y
– ident: e_1_3_1_12_2
  doi: 10.1016/j.amjcard.2009.03.058
– ident: e_1_3_1_33_2
  doi: 10.1016/j.ijcard.2017.04.073
– ident: e_1_3_1_6_2
  doi: 10.1007/s00246-014-0888-4
– ident: e_1_3_1_23_2
  doi: 10.1161/hc3801.096326
– ident: e_1_3_1_30_2
  doi: 10.1186/s12872-017-0705-0
– ident: e_1_3_1_18_2
  doi: 10.1007/s10741-019-09904-z
– ident: e_1_3_1_17_2
  doi: 10.1001/jamacardio.2019.5459
– ident: e_1_3_1_31_2
  doi: 10.1161/CIRCULATIONAHA.117.029058
– ident: e_1_3_1_35_2
  doi: 10.1016/j.echo.2016.07.016
– ident: e_1_3_1_28_2
  doi: 10.1007/s00246-018-1819-6
– ident: e_1_3_1_36_2
  doi: 10.1136/heartjnl-2015-309042
– ident: e_1_3_1_5_2
  doi: 10.1161/CIRCIMAGING.112.000175
– ident: e_1_3_1_34_2
  doi: 10.1016/j.jacc.2017.03.582
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Snippet Background Heart failure phenotyping in single-ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The...
Background Heart failure phenotyping in single‐ventricle Fontan patients is challenging, particularly in patients with normal ejection fraction (EF). The...
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StartPage e024095
SubjectTerms Child
Cross-Sectional Studies
Diastole
diastolic function
Fontan
Fontan Procedure - adverse effects
Heart Failure
Humans
Original Research
single ventricle
Stroke Volume
Ventricular Function, Left
Title Diastolic Dysfunction With Preserved Ejection Fraction After the Fontan Procedure
URI https://www.ncbi.nlm.nih.gov/pubmed/35023347
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https://pubmed.ncbi.nlm.nih.gov/PMC9238510
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