Congenital heart diseaseCross-sectional study
Exercise Catheterization in Adults Post-Fontan with Normal and Abnormal Haemodynamic Criteria: Insights Into Normal Fontan Physiology
- Cross-sectional study
Authors' conclusion
PAWP >20 mmHg and mean PA pressure >25 mmHg could be used to define elevated values during exercise in adults post-Fontan. The major discrepancy in exercise haemodynamics among Group II compared to controls appears to be the degree of systemic venous hypertension and arterial desaturation.
Study context
- Population
- Adults post-Fontan undergoing exercise catheterization72 post-Fontan + 39 non-cardiac dyspnoea (NCD) controls
- Participants
- 59 / 13 / 39
- Exposure
- Group I vs Group II vs NCD
- Group In = 59
- Group IIn = 13reference
- NCDn = 39
- Outcome
- Elevated exercise PAWP and mean PA pressure post-Fontan (2 SD above Group II means)
Main finding
As reported in the abstract
Thresholds for elevated exercise pressures (2 SD above Group II mean) · exercise
Elevated PA wedge pressure (PAWP)
20.6 mmHg
Elevated mean pulmonary artery (PA) pressure
25.8 mmHg
Observational data: associations, not effects.
Further findings
| Outcome | Group I | Group II | NCD | P value |
|---|---|---|---|---|
| Exercise arterial oxygen saturation, Group I vs Group II | 87% (range 81–92) | 89% (range 85–93) | Not reported in the abstract | P = 0.29 |
| Exercise PA pressure, Group I vs Group II | 27 (range 23–31) mmHg | 16 (range 14.5–19.5) mmHg | Not reported in the abstract | P < 0.001 |
| Exercise PAWP, Group I vs Group II | 21 (range 18–28) mmHg | 12 (range 8–14) mmHg | Not reported in the abstract | P < 0.001 |
| Peak heart rate, Group I vs Group II · peak exercise | 97 (range 81–120) bpm | 133 (range 112.5–147.5) bpm | Not reported in the abstract | P < 0.001 |
| Peak Qs response, Group I vs Group II · peak exercise | 67.3 (range 43.8–93.1) % predicted | 105.9 (range 82–118.5) % predicted | Not reported in the abstract | P < 0.001 |
| Exercise superior vena cava pressure, Group II vs NCD | Not reported in the abstract | 16 (range 14–22.5) mmHg | 5.5 (range 3–7.3) mmHg | P < 0.001 |
| Exercise arterial oxygen saturation, Group II vs NCD | Not reported in the abstract | 89% (range 85–93) | 97% (range 96–98) | P < 0.001 |
PAWP, stroke volume index, heart rate, Qs response: Group II vs NCD · exercise
- No differences between Group II and NCD
Original publication
Exercise Catheterization in Adults Post-Fontan with Normal and Abnormal Haemodynamic Criteria: Insights Into Normal Fontan Physiology. Eur J Heart Fail. Published 1 February 2024. doi:10.1002/ejhf.3119
Summarised from the published abstract; every number is checked against it