Exercise capacity in the Danish Fontan population remains stable after ten years of follow-up - is physical activity the key to success?

Ravndal, Maren E H; Idorn, Lars; Nielsen, Anne Kathrine M.; Kelly, Benjamin; Nielsen, Kim G.; Nielsen, Dorte Guldbrand; Hjortdal, Vibeke E.

doi:10.1016/j.ijcard.2023.131137

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…It is well established that DLNO is strongly correlated with VO2 peak in healthy people [ 41 , 42 ], which we also found in our patients. Recent studies, including our own data [ 15 , 43 ], suggest that increased physical activity can affect VO2 peak in Fontan patients. Physical activity might, therefore, have a more beneficial impact on lung function in Fontan patients than previously assumed.…”

Section: Discussionmentioning

confidence: 84%

“…As part of the national Fontan studies in both 2011 and 2021, patients were also invited to a cardiopulmonary exercise test (CPET). CPET results are published in a separate manuscript [ 15 ], but selected data from the CPETs in 2021 are also presented here—to identify possible associations between PFT measurements and VO2 peak . The study was approved by the National Scientific Ethics Committee (H-20028226), and all patients provided written informed consent before the investigations.…”

Section: Methodsmentioning

confidence: 99%

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Lung Function in Fontan Patients Over a Ten-Year Period: Is the Fontan Circulation Impairing Lung Development?

Ravndal,

Idorn,

Nielsen

et al. 2024

Pediatr Cardiol

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Few studies have investigated how the Fontan circulation affects lung function, and no studies have investigated the development of lung function over longer time in these patients. We aimed to describe the development of lung function in Fontan patients over a 10-year period. Pulmonary function tests (PFT), including spirometry and diffusion capacity for Carbon Monoxide (DLCO) and Nitric Oxide (DLNO), were conducted in a Danish Fontan cohort in 2011 (PFT-I). In 2021, re-investigations were performed (PFT-II). We investigated changes in percent predicted (%pred) lung function from PFT-I to PFT-II. Patients were categorized into a pediatric group (age under 18 at PFT-I) and an adult group (age 18 or older at PFT-I). Out of the 81 patients completing PFT-I, 48 completed PFT-II. In the pediatric group (32 patients), there were significant declines in %pred forced expiratory volume in 1s (99.7 (92.4, 104.4)–89.3 (84.9, 97.2), p < 0,001), forced vital capacity (98.3 (87.8, 106.1)–96.7 (86.7, 100.6), p = 0.008), and alveolar volume (95.5 (89.5, 101.6)–89.5 (79.7, 93.2), p < 0.001). The corresponding measurements remained stable in the adult group. However, the median %pred DLNO significantly declined in the adult group (58.4 (53.3, 63.5)–53.7 (44.1, 57.3), p = 0.005). Over a 10-year period, several lung function parameters declined significantly in the younger Fontan patients, suggesting possible impairments in lung development during growth. The decline in %pred DLNO in the adult patient group indicates deterioration of the membrane component of diffusion capacity, implying that the Fontan circulation might negatively affect the alveolar membrane over time.

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Section: Discussionmentioning

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Lung Function in Fontan Patients Over a Ten-Year Period: Is the Fontan Circulation Impairing Lung Development?

Ravndal,

Idorn,

Nielsen

et al. 2024

Pediatr Cardiol

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Long-term outcomes of extracardiac Gore-Tex conduits in Fontan patients

Lee,

Song,

Lee

et al. 2024

International Journal of Cardiology Congenital Heart Disease

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Psychiatric co-morbidities and feasibility of an online psychiatric screening measure in children and adolescents with the Fontan circulation

Lau-Jensen,

Hejl,

Thorup

et al. 2024

Cardiol Young

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Background: Guidelines recommend screening for psychiatric co-morbidities in patients with congenital heart defects alongside cardiac outpatient follow-ups. These recommendations are not implemented in Denmark. This study aimed to investigate the psychiatric co-morbidities in children and adolescents with Fontan circulation in Denmark and to evaluate the feasibility of an online screening measure for psychiatric disorders. Methods: Children, adolescents, and their families answered the Development and Well-Being Assessment questionnaire and a questionnaire about received help online. Development and Well-Being Assessment ratings present psychiatric diagnoses in accordance with ICD-10 and DSM-5. Parent-reported received psychiatric help is also presented. Feasibility data are reported as participation rate (completed Development and Well-Being Assessments) and parental/adolescent acceptability from the feasibility questionnaire. Results: The participation rate was 27%. Of the participating children and adolescents, 53% (ICD-10)/59% (DSM-5) met full diagnostic criteria for at least one psychiatric diagnosis. Of these, 50% had not received any psychiatric or psychological help. Only 12% of participants had an a priori psychiatric diagnosis. Conclusions: We found that a large proportion of children and adolescents with Fontan circulation are underdiagnosed and undertreated for psychiatric disorders. The results from our study emphasise the need for psychiatric screening in this patient group. Development and Well-Being Assessment may be too comprehensive for online electronic screening in children and adolescents with CHD.

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Exercise capacity in the Danish Fontan population remains stable after ten years of follow-up - is physical activity the key to success?

Cited by 3 publications

References 21 publications

Lung Function in Fontan Patients Over a Ten-Year Period: Is the Fontan Circulation Impairing Lung Development?

Lung Function in Fontan Patients Over a Ten-Year Period: Is the Fontan Circulation Impairing Lung Development?

Long-term outcomes of extracardiac Gore-Tex conduits in Fontan patients

Psychiatric co-morbidities and feasibility of an online psychiatric screening measure in children and adolescents with the Fontan circulation

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