Growth in Children with a Fontan Circulation - 22/07/21
, Benjamin Zielonka, MD 3, Jeffrey D. Roizen, MD 1, 2, Kathryn M. Dodds, MSN 4, 5, Elizabeth B. Rand, MD 1, 6, Jennifer R. Heimall, MD 1, 7, Feiyan Chen, PhD 8, Chao Wu, PhD 8, David J. Goldberg, MD 1, 4, Jack Rychik, MD 1, 4Abstract |
Objective |
To evaluate growth in a population of patients with Fontan circulation.
Study design |
We performed a cross-sectional evaluation of patients followed in our multidisciplinary Fontan clinic from January 2011 through August 2015. We reviewed the historical data, anthropometry, clinical, and laboratory studies and performed bivariate and multivariate analysis of factors associated with height z score.
Results |
Patients (n = 210) were included in the study at median age 11.07 years (8.3, 14.73 years) (43% female); 138 (65%) had a dominant right systemic ventricle and 92 (44%) hypoplastic left heart syndrome. Median age at completion of Fontan circulation was 31 months (7.6, 135.8 months). Median height z score was −0.58 (−1.75, 0.26). Twenty-five (12%) had current or past history of protein-losing enteropathy (PLE). Median height z score for those with current or past history of PLE was −2.1 (−2.46, 1.24). Multivariate analysis revealed positive associations between height z score and body mass index z score, time since Fontan, mid-parental height, dominant systemic ventricle type, and serum alkaline phosphatase. Height correlated negatively with known genetic syndrome, PLE, use of stimulant or oral steroid medication.
Conclusions |
Children with Fontan circulation have mild deficits in height, with greater deficits in those with PLE. Height z score improves with time postsurgery. Improving weight, leading to improved body mass index, may be a modifiable factor that improves growth in those who are underweight. Biochemical markers may be helpful screening tests for high-risk groups in whom to intensify interventions.
Le texte complet de cet article est disponible en PDF.Keywords : single ventricle, congenital heart disease, protein losing enteropathy, height z score
Abbreviations : AV, BMI, MPH, PLE, PTH
Plan
| J.R. receives research support for Fontan circulation from the Robert and Dolores Harrington Endowed Chair in Cardiology at The Children's Hospital of Philadelphia. The other authors declare no conflicts of interest. |
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| Portions of this study were presented at the Scientific Sessions of the American Heart Association 2016 Scientific Sessions November 12-16, 2016, New Orleans, Louisiana. |
Vol 235
P. 149 - août 2021 Retour au numéro
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