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Body mass index and age are associated with ventricular end-diastolic pressure in adults with a Fontan circulation

Published online by Cambridge University Press:  07 October 2021

Mary Howell Open the ORCID record for Mary Howell [Opens in a new window] ,
William E. Anderson ,
Jorge Alegria ,
Joseph Paolillo  and
Matthew C. Schwartz Open the ORCID record for Matthew C. Schwartz [Opens in a new window]
Mary Howell*
Affiliation:
Division of Pediatric Cardiology, University of Utah, Salt Lake City, UT, USA
William E. Anderson
Affiliation:
Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC, USA
Jorge Alegria
Affiliation:
Sanger Heart and Vascular Institute, Charlotte, NC, USA
Joseph Paolillo
Affiliation:
Sanger Heart and Vascular Institute, Charlotte, NC, USA Levine Children’s Hospital, Charlotte, NC, USA
Matthew C. Schwartz
Affiliation:
Sanger Heart and Vascular Institute, Charlotte, NC, USA Levine Children’s Hospital, Charlotte, NC, USA
*
Author for correspondence: M. Howell, MD, Division of Pediatric Cardiology, University of Utah, 769 E Barrows Ave, Salt Lake City, UT 84106, USA. Tel: (914)414-5883. E-mail: Mary.Howell@hsc.utah.edu
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Abstract

Introduction:

Systemic ventricular end-diastolic pressure is an important haemodynamic variable in adult patients with Fontan circulation. Risk factors associated with elevated end-diastolic pressure have not been clearly identified in this population.

Methods:

All patients > 18 years with Fontan circulation who underwent cardiac catheterisation at our centre between 1/08 and 3/19 were included. Relevant patient variables were extracted. Univariate and multivariate general linear models were analysed to identify variables associated with end-diastolic pressure.

Results:

Forty-two patients were included. Median age was 24.0 years (20.9–29.0) with a body mass index of 23.7 kg/m2 (21.5–29.7). 10 (23.8%) patients had a systemic right ventricle. The median (Interquartile range) and mean pulmonary artery pressure were 11.0 mmHg (9.0–12.0) and 16.0 mmHg (13.0–18.0), respectively. On univariate analysis, end-diastolic pressure was positively associated with body mass index (p < 0.01), age > 25 years (p = 0.04), symptoms of heart failure (p < 0.01), systemic ventricular systolic pressure (p = 0.03), pulmonary artery mean pressure (p < 0.01), and taking diuretics (p < 0.01) or sildenafil (p < 0.01). End-diastolic pressure was negatively associated with aortic saturation (p < 0.01). On multivariate analysis, end-diastolic pressure was positively associated with age ≥ 25 years (p < 0.01), and body mass index (p = 0.04).

Conclusions:

In a cohort of adult patients with Fontan circulation undergoing catheterisation, end-diastolic pressure was positively associated with age ≥ 25 years and body mass index on multivariate analysis. Maintaining a healthy body mass index may offer haemodynamic benefit in adults with Fontan physiology.

Keywords

Fontanbody mass indexadultend-diastolic pressure
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 8 , August 2022 , pp. 1296 - 1301
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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