Prevalence of Elevated Body Mass Index and Its Association with Clinical Features in Adult Fontan Patients (original) (raw)

2017, Journal of the American College of Cardiology

Background: Elevated body mass index (BMI) is increasingly affecting adults with congenital heart disease. The effect of an increased BMI with respect to clinical variables has not been evaluated in adult Fontan patients. Methods: Retrospective review of medical records from 2 tertiary academic institutions identified 68 Fontan patients ≥ 18 years for whom BMI data was available. Results: Mean BMI was 24±4 kg/m 2 with 6% being underweight (BMI <18.5), 54% normal (18.5-<25), 31% overweight (25-<30) and 9% obese (≥ 30). Patients with BMI ≥ 25 kg/m 2 were significantly older (34 ± 9 vs. 31 ± 7 yrs, p=0.03), had higher Fontan (16 ± 3 vs.14 ± 6 mm Hg, p=0.04) and pulmonary capillary wedge pressures (PCWP, 12 ± 3 vs. 9 ± 3 mm Hg, p=0.03) and lower peak oxygen consumption (VO 2 , 18±5 vs. 22±4 ml/Kg/min, p=0.005), minute ventilation (Ve, 44 ± 10 vs. 58 ± 21 L/min, p=0.03) and Ve/Vco2, (33 ± 7 vs. 36 ± 4, p=0.03) on cardiopulmonary exercise testing (CPET). There were no differences in gender, Fontan type, ventricular type and function, arrhythmia burden, New York Heart Association status, other echocardiographic, hemodynamic or CPET variables. Linear regression graph showed a linear correlation between BMI and the significant clinical variables (Figure). Conclusions: Overweight/obesity is highly prevalent in adult Fontan patients. Higher BMI is associated with poor hemodynamics and aerobic capacity. This might correlate with worse health outcomes in this patient population, although further study is needed to determine this.