Cohort study
Exercise Capacity, NT-proBNP, and Exercise Hemodynamics in Adults Post-Fontan
- Retrospective cohort study
Authors' conclusion
In adults post-Fontan, resting and exercise FP and PAWP were inversely related to exercise capacity on noninvasive CPET, and exercise hemodynamics were directly related to NT-proBNP levels. Exercise FP and PAWP were independently associated with clinical outcomes and might be more sensitive than resting values to predict clinical outcomes.
Study context
- Population
- Adults (age ≥18 years) post-Fontan undergoing supine exercise venous catheterization, 2018–2022
- Participants
- 50 adults
- Exposure
- Peak VO2 <50% predicted vs more preserved exercise capacity; NT-proBNP ≥300 pg/mL vs lower
- Outcome
- Correlation of resting and exercise Fontan pressures (FP) and PAWP with peak VO2 on cardiopulmonary exercise testing (CPET), NT-proBNP and clinical outcomes
Main finding
As reported in the abstract
Exercise FP and PAWP by exercise capacity
| Group | Exercise Fontan pressures (FP) | Exercise pulmonary artery wedge pressure (PAWP) |
|---|---|---|
| Peak VO2 <50% predicted | 30.0 ± 6.8 mm Hg | 25.9 ± 6.3 mm Hg |
| More preserved exercise capacity | 19 mm Hg [IQR: 16-24 mm Hg] | 15.1 ± 7.0 mm Hg |
- Peak VO2 <50% predicted vs More preserved exercise capacity: P < 0.001 — exercise FP
- Peak VO2 <50% predicted vs More preserved exercise capacity: P < 0.001 — exercise PAWP
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Exercise FP and PAWP by NT-proBNP ≥300 pg/mL — NT-proBNP ≥300 pg/mL vs More preserved exercise capacity · exercise FP 30.0 ± 7.1 vs 23.2 ± 7.2 mm Hg | P = 0.003 |
| Exercise FP and PAWP by NT-proBNP ≥300 pg/mL — NT-proBNP ≥300 pg/mL vs More preserved exercise capacity · exercise PAWP 25.1 ± 6.7 vs 18.8 ± 7.9 mm Hg | P = 0.006 |
Composite of death, cardiac transplantation or HF/refractory arrhythmia hospitalization · follow-up 0.9 years (IQR: 0.6-2.9 years)
- Exercise FP and PAWP independently associated after adjusting for confounders
Original publication
Exercise Capacity, NT-proBNP, and Exercise Hemodynamics in Adults Post-Fontan. J Am Coll Cardiol. Published 25 April 2023. doi:10.1016/j.jacc.2023.02.031
Summarised from the published abstract; every number is checked against it