Impact of adiposity on clinical outcomes in people living with a Fontan circulation.
Int J Cardiol
; 329: 82-88, 2021 04 15.
Article
en En
| MEDLINE
| ID: mdl-33387555
ABSTRACT
BACKGROUND:
To assess the association between body composition and the risk of adverse outcomes in Fontan patients.METHODS:
Participants from the Australian and New Zealand Fontan Registry with dual-energy X-ray absorptiometry scans were included. Appendicular lean mass (ALM), appendicular lean mass index (ALM divided by height squared; ALMI) and total body fat mass percentage (%BF) were calculated. ALMI and %BF z-scores were derived using age- and sex-matched reference ranges. The primary outcome was Fontan failure (death, transplantation, New York Heart Association functional class III/IV, protein-losing enteropathy, and plastic bronchitis) or moderate-or-severe ventricular dysfunction.RESULTS:
144 patients were included. Mean %BF was 29% (SD 10) with 50% having increased adiposity. Mean ALMI z-score was -1.4 (SD 1.1); one third of patients had skeletal muscle deficiency (ALMI z-score < -1 and -2) and another third had Fontan-associated myopaenia (ALMI z-score < -2). Age and %BF were associated with the risk of the endpoint in univariable regression (age HR 1.09 per year, 95% CI 1.02-1.17, p = 0.01; %BF HR 1.08, 95% CI 1.01-1.17, p = 0.03). On multivariable regression, every 1% increase in %BF was associated with a 10% increased risk of reaching the clinical endpoint (HR 1.10, 95% CI 1.01-1.19; p = 0.03). ALM was not associated with the endpoint (HR 1.02 per kg, 95% CI 0.88-1.20, p = 0.77).CONCLUSIONS:
Increased adiposity is associated with higher risk for adverse outcomes. Prospective studies to assess lifestyle interventions to optimise body composition should be prioritised.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Procedimiento de Fontan
/
Adiposidad
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Int J Cardiol
Año:
2021
Tipo del documento:
Article
País de afiliación:
Australia