Laboratory Measures of Exercise Capacity and Ventricular Characteristics and Function Are Weakly Associated With Functional Health Status After Fontan Procedure
Patients after the Fontan procedure are at risk for suboptimal functional health status, and associations with laboratory measures are important for planning interventions and outcome measures for clinical trials. Parents completed the generic Child Health Questionnaire for 511 Fontan Cross-Sectiona...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2010-01, Vol.121 (1), p.34-42 |
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| creator | MCCRINDLE, Brian W ZAK, Victor WILLIAMS, Richard V GERSONY, Welton M ATZ, Andrew M SLEEPER, Lynn A PARIDON, Stephen M COLAN, Steven D GEVA, Tal MAHONY, Lynn LI, Jennifer S BREITBART, Roger E MARGOSSIAN, Renee |
| description | Patients after the Fontan procedure are at risk for suboptimal functional health status, and associations with laboratory measures are important for planning interventions and outcome measures for clinical trials.
Parents completed the generic Child Health Questionnaire for 511 Fontan Cross-Sectional Study patients 6 to 18 years of age (61% male). Associations of Child Health Questionnaire Physical and Psychosocial Functioning Summary Scores (FSS) with standardized measurements from prospective exercise testing, echocardiography, magnetic resonance imaging, and measurement of brain natriuretic peptide were determined by regression analyses. For exercise variables for maximal effort patients only, the final model showed that higher Physical FSS was associated only with higher maximum work rate, accounting for 9% of variation in Physical FSS. For echocardiography, lower Tei index (particularly for patients with extracardiac lateral tunnel connections), lower indexed end-systolic volume, and the absence of atrioventricular valve regurgitation for patients having Fontan procedure at age |
| doi_str_mv | 10.1161/CIRCULATIONAHA.109.869396 |
| format | Article |
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Parents completed the generic Child Health Questionnaire for 511 Fontan Cross-Sectional Study patients 6 to 18 years of age (61% male). Associations of Child Health Questionnaire Physical and Psychosocial Functioning Summary Scores (FSS) with standardized measurements from prospective exercise testing, echocardiography, magnetic resonance imaging, and measurement of brain natriuretic peptide were determined by regression analyses. For exercise variables for maximal effort patients only, the final model showed that higher Physical FSS was associated only with higher maximum work rate, accounting for 9% of variation in Physical FSS. For echocardiography, lower Tei index (particularly for patients with extracardiac lateral tunnel connections), lower indexed end-systolic volume, and the absence of atrioventricular valve regurgitation for patients having Fontan procedure at age <2 years were associated with higher Physical FSS, accounting for 14% of variation in Physical FSS. For magnetic resonance imaging, ratio of lower mass to end-diastolic volume and midquartiles of indexed end-systolic volume (nonlinear) were associated with higher Physical FSS, accounting for 11% of variation. Lower brain natriuretic peptide was significantly but weakly associated with higher Physical FSS (1% of variation). Significant associations for Psychosocial FSS with laboratory measures were fewer and weaker than for Physical FSS.
In relatively healthy Fontan patients, laboratory measures account for a small proportion of the variation in functional health status and therefore may not be optimal surrogate end points for trials of therapeutic interventions.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.109.869396</identifier><identifier>PMID: 20026781</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood coagulation ; Cardiac Volume ; Cardiology. Vascular system ; Child ; Cross-Sectional Studies ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Echocardiography ; Exercise Test ; Exercise Tolerance - physiology ; Female ; Fontan Procedure ; Health Status ; Heart Defects, Congenital - surgery ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Natriuretic Peptide, Brain - blood ; Postoperative Complications - diagnostic imaging ; Postoperative Complications - pathology ; Postoperative Complications - physiopathology ; Surveys and Questionnaires ; Ventricular Dysfunction - diagnostic imaging ; Ventricular Dysfunction - pathology ; Ventricular Dysfunction - physiopathology</subject><ispartof>Circulation (New York, N.Y.), 2010-01, Vol.121 (1), p.34-42</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-2b80b520acfa737a17db68814b5be07b19a94c4fd2d261ae63f30163072334ec3</citedby><cites>FETCH-LOGICAL-c437t-2b80b520acfa737a17db68814b5be07b19a94c4fd2d261ae63f30163072334ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22333333$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20026781$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MCCRINDLE, Brian W</creatorcontrib><creatorcontrib>ZAK, Victor</creatorcontrib><creatorcontrib>WILLIAMS, Richard V</creatorcontrib><creatorcontrib>GERSONY, Welton M</creatorcontrib><creatorcontrib>ATZ, Andrew M</creatorcontrib><creatorcontrib>SLEEPER, Lynn A</creatorcontrib><creatorcontrib>PARIDON, Stephen M</creatorcontrib><creatorcontrib>COLAN, Steven D</creatorcontrib><creatorcontrib>GEVA, Tal</creatorcontrib><creatorcontrib>MAHONY, Lynn</creatorcontrib><creatorcontrib>LI, Jennifer S</creatorcontrib><creatorcontrib>BREITBART, Roger E</creatorcontrib><creatorcontrib>MARGOSSIAN, Renee</creatorcontrib><creatorcontrib>Pediatric Heart Network Investigators</creatorcontrib><title>Laboratory Measures of Exercise Capacity and Ventricular Characteristics and Function Are Weakly Associated With Functional Health Status After Fontan Procedure</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Patients after the Fontan procedure are at risk for suboptimal functional health status, and associations with laboratory measures are important for planning interventions and outcome measures for clinical trials.
Parents completed the generic Child Health Questionnaire for 511 Fontan Cross-Sectional Study patients 6 to 18 years of age (61% male). Associations of Child Health Questionnaire Physical and Psychosocial Functioning Summary Scores (FSS) with standardized measurements from prospective exercise testing, echocardiography, magnetic resonance imaging, and measurement of brain natriuretic peptide were determined by regression analyses. For exercise variables for maximal effort patients only, the final model showed that higher Physical FSS was associated only with higher maximum work rate, accounting for 9% of variation in Physical FSS. For echocardiography, lower Tei index (particularly for patients with extracardiac lateral tunnel connections), lower indexed end-systolic volume, and the absence of atrioventricular valve regurgitation for patients having Fontan procedure at age <2 years were associated with higher Physical FSS, accounting for 14% of variation in Physical FSS. For magnetic resonance imaging, ratio of lower mass to end-diastolic volume and midquartiles of indexed end-systolic volume (nonlinear) were associated with higher Physical FSS, accounting for 11% of variation. Lower brain natriuretic peptide was significantly but weakly associated with higher Physical FSS (1% of variation). Significant associations for Psychosocial FSS with laboratory measures were fewer and weaker than for Physical FSS.
In relatively healthy Fontan patients, laboratory measures account for a small proportion of the variation in functional health status and therefore may not be optimal surrogate end points for trials of therapeutic interventions.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood coagulation</subject><subject>Cardiac Volume</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Cross-Sectional Studies</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Echocardiography</subject><subject>Exercise Test</subject><subject>Exercise Tolerance - physiology</subject><subject>Female</subject><subject>Fontan Procedure</subject><subject>Health Status</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - pathology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Surveys and Questionnaires</subject><subject>Ventricular Dysfunction - diagnostic imaging</subject><subject>Ventricular Dysfunction - pathology</subject><subject>Ventricular Dysfunction - physiopathology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc1u1DAQgC0EotvCKyBzQJyy-CeJ42MUddmVFoqgpcdo4kxUQzbe2o7Evg2PWtNdivBl5JlvfqSPkLecLTkv-Ydm87W52dbXm6vP9bpecqaXVamlLp-RBS9EnuWF1M_JgjGmMyWFOCPnIfxI31Kq4iU5E4yJUlV8QX5voXMeovMH-gkhzB4DdQO9_IXe2IC0gT0YGw8Upp5-xyl6a-YRPG3uwIOJ6G2I1oTH-mqeTLRuorVHeovwczzQOgRnLETs6a2Nd08MjHSNMKbMtwhxDrQe0jC6clOEiX7xzmCfrnlFXgwwBnx9ihfkZnV53ayz7dXHTVNvM5NLFTPRVawrBAMzgJIKuOq7sqp43hUdMtVxDTo3-dCLXpQcsJSDZLyUTAkpczTygrw_zt17dz9jiO3OBoPjCBO6ObRK5kKwShaJ1EfSeBeCx6Hde7sDf2g5a__4af_3k9K6PfpJvW9OW-Zuh_1T518hCXh3AiAYGAcPU9Lwj0vXPr4H_hSdPQ</recordid><startdate>20100105</startdate><enddate>20100105</enddate><creator>MCCRINDLE, Brian W</creator><creator>ZAK, Victor</creator><creator>WILLIAMS, Richard V</creator><creator>GERSONY, Welton M</creator><creator>ATZ, Andrew M</creator><creator>SLEEPER, Lynn A</creator><creator>PARIDON, Stephen M</creator><creator>COLAN, Steven D</creator><creator>GEVA, Tal</creator><creator>MAHONY, Lynn</creator><creator>LI, Jennifer S</creator><creator>BREITBART, Roger E</creator><creator>MARGOSSIAN, Renee</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100105</creationdate><title>Laboratory Measures of Exercise Capacity and Ventricular Characteristics and Function Are Weakly Associated With Functional Health Status After Fontan Procedure</title><author>MCCRINDLE, Brian W ; ZAK, Victor ; WILLIAMS, Richard V ; GERSONY, Welton M ; ATZ, Andrew M ; SLEEPER, Lynn A ; PARIDON, Stephen M ; COLAN, Steven D ; GEVA, Tal ; MAHONY, Lynn ; LI, Jennifer S ; BREITBART, Roger E ; MARGOSSIAN, Renee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-2b80b520acfa737a17db68814b5be07b19a94c4fd2d261ae63f30163072334ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Blood coagulation</topic><topic>Cardiac Volume</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Cross-Sectional Studies</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Echocardiography</topic><topic>Exercise Test</topic><topic>Exercise Tolerance - physiology</topic><topic>Female</topic><topic>Fontan Procedure</topic><topic>Health Status</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - pathology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Surveys and Questionnaires</topic><topic>Ventricular Dysfunction - diagnostic imaging</topic><topic>Ventricular Dysfunction - pathology</topic><topic>Ventricular Dysfunction - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MCCRINDLE, Brian W</creatorcontrib><creatorcontrib>ZAK, Victor</creatorcontrib><creatorcontrib>WILLIAMS, Richard V</creatorcontrib><creatorcontrib>GERSONY, Welton M</creatorcontrib><creatorcontrib>ATZ, Andrew M</creatorcontrib><creatorcontrib>SLEEPER, Lynn A</creatorcontrib><creatorcontrib>PARIDON, Stephen M</creatorcontrib><creatorcontrib>COLAN, Steven D</creatorcontrib><creatorcontrib>GEVA, Tal</creatorcontrib><creatorcontrib>MAHONY, Lynn</creatorcontrib><creatorcontrib>LI, Jennifer S</creatorcontrib><creatorcontrib>BREITBART, Roger E</creatorcontrib><creatorcontrib>MARGOSSIAN, Renee</creatorcontrib><creatorcontrib>Pediatric Heart Network Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MCCRINDLE, Brian W</au><au>ZAK, Victor</au><au>WILLIAMS, Richard V</au><au>GERSONY, Welton M</au><au>ATZ, Andrew M</au><au>SLEEPER, Lynn A</au><au>PARIDON, Stephen M</au><au>COLAN, Steven D</au><au>GEVA, Tal</au><au>MAHONY, Lynn</au><au>LI, Jennifer S</au><au>BREITBART, Roger E</au><au>MARGOSSIAN, Renee</au><aucorp>Pediatric Heart Network Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laboratory Measures of Exercise Capacity and Ventricular Characteristics and Function Are Weakly Associated With Functional Health Status After Fontan Procedure</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2010-01-05</date><risdate>2010</risdate><volume>121</volume><issue>1</issue><spage>34</spage><epage>42</epage><pages>34-42</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Patients after the Fontan procedure are at risk for suboptimal functional health status, and associations with laboratory measures are important for planning interventions and outcome measures for clinical trials.
Parents completed the generic Child Health Questionnaire for 511 Fontan Cross-Sectional Study patients 6 to 18 years of age (61% male). Associations of Child Health Questionnaire Physical and Psychosocial Functioning Summary Scores (FSS) with standardized measurements from prospective exercise testing, echocardiography, magnetic resonance imaging, and measurement of brain natriuretic peptide were determined by regression analyses. For exercise variables for maximal effort patients only, the final model showed that higher Physical FSS was associated only with higher maximum work rate, accounting for 9% of variation in Physical FSS. For echocardiography, lower Tei index (particularly for patients with extracardiac lateral tunnel connections), lower indexed end-systolic volume, and the absence of atrioventricular valve regurgitation for patients having Fontan procedure at age <2 years were associated with higher Physical FSS, accounting for 14% of variation in Physical FSS. For magnetic resonance imaging, ratio of lower mass to end-diastolic volume and midquartiles of indexed end-systolic volume (nonlinear) were associated with higher Physical FSS, accounting for 11% of variation. Lower brain natriuretic peptide was significantly but weakly associated with higher Physical FSS (1% of variation). Significant associations for Psychosocial FSS with laboratory measures were fewer and weaker than for Physical FSS.
In relatively healthy Fontan patients, laboratory measures account for a small proportion of the variation in functional health status and therefore may not be optimal surrogate end points for trials of therapeutic interventions.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>20026781</pmid><doi>10.1161/CIRCULATIONAHA.109.869396</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2010-01, Vol.121 (1), p.34-42 |
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| source | MEDLINE; EZB Electronic Journals Library; American Heart Association; Journals@Ovid Complete |
| subjects | Adolescent Biological and medical sciences Blood and lymphatic vessels Blood coagulation Cardiac Volume Cardiology. Vascular system Child Cross-Sectional Studies Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Echocardiography Exercise Test Exercise Tolerance - physiology Female Fontan Procedure Health Status Heart Defects, Congenital - surgery Humans Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging Male Medical sciences Natriuretic Peptide, Brain - blood Postoperative Complications - diagnostic imaging Postoperative Complications - pathology Postoperative Complications - physiopathology Surveys and Questionnaires Ventricular Dysfunction - diagnostic imaging Ventricular Dysfunction - pathology Ventricular Dysfunction - physiopathology |
| title | Laboratory Measures of Exercise Capacity and Ventricular Characteristics and Function Are Weakly Associated With Functional Health Status After Fontan Procedure |
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