Associations between Bodyweight and Clinical Outcome in Patients Post-Fontan Procedure: A Systematic Review  

作　　者：Emma Payne Thomas Wilson Marjan Haghighi Zoe McCallum Yves d’Udekem Julian Ayer 

机构地区：[1]The University of Sydney,Sydney,Australia [2]The University of Melbourne,Melbourne,Australia [3]The Royal Children’s Hospital,Melbourne,Australia [4]The Royal Prince Alfred Hospital,Sydney,Australia [5]The Children’s National Hospital,Washington,USA

出　　处：《Congenital Heart Disease》2022年第6期617-639,共23页先天性心脏病（英文）

基　　金：the recipient of a National Health and Medical Research Council(NHMRC)Postgraduate Scholarship(GNT1168270).

摘　　要：Background: Patients born with a single ventricle circulation commonly experience growth failure in early life,which is associated with adverse outcomes in infancy. However, associations between bodyweight or weight trajectoryand clinical outcome post-Fontan procedure are yet to be determined. Methods: On the 1st of July 2021, asystematic review was performed in MEDLINE, EMBASE, the Cochrane Library, and Scopus of studies of patientswith clinical outcome data post-Fontan procedure and association with bodyweight. Quality of studies was evaluatedby Newcastle–Ottawa scale for cohort studies and Joanna Briggs Institute tool for cross-sectional studies.Results: Of 527 studies that underwent title and abstract screening, 15 were selected for final review. An increasedrisk of adverse post-Fontan outcomes was found for low weight patients, consistent with findings in infants.Whilst there is some evidence to suggest increased mortality in overweight adult patients, studies are conflictingas to whether overweight status is associated with increased heart failure. Increased BMI is associated with diminishedexercise capacity and deceased physiological functioning. Negative weight trajectory is associated withadverse outcomes in the peri-Fontan period, whereas a positive weight trajectory is associated with increased Fontanfailure in adulthood. Abnormal BMI (high or low) is associated with increased heart failure and poorer performancein quality-of-life scores. Conclusions: Bodyweight is a modifiable risk factor for poor clinical outcomein patients with a single ventricle circulation. Recognizing associations between bodyweight and Fontan pathophysiologymay help to define patient-centered exercise and diet interventions that minimize patient morbidityand mortality.

关 键 词：FONTAN BODYWEIGHT congenital heart disease single ventricle 

分 类 号：R541[医药卫生—心血管疾病]