ArticleHeart (British Cardiac Society)2014
Lean mass deficits, vitamin D status and exercise capacity in children and young adults after Fontan palliation.
Article in Heart (British Cardiac Society), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Fontan Circulation Associated Organ Abnormalities Beyond the Heart, Lungs, Liver, and Gut: A Systematic Review.Frontiers in cardiovascular medicine · 2022Pooled it
- Overweight and Obesity in Patients with Congenital Heart Disease: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Increases in IGF-1 After Anti-TNF-α Therapy Are Associated With Bone and Muscle Accrual in Pediatric Crohn Disease.The Journal of clinical endocrinology and metabolism · 2018Trial
- Effect of Low-Magnitude Mechanical Stimuli on Bone Density and Structure in Pediatric Crohn's Disease: A Randomized Placebo-Controlled Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2016Trial
- Magnetic Resonance Imaging-Based Psoas Muscle Volume as an Additional Risk Factor for Fontan Failure: A Prospective Cohort Study.Journal of the American Heart Association · 2026Article
- Prevalence of Overweight and Obesity in Pediatric Congenital Heart Disease: Associations with Hypertension and Echocardiographic Findings.Children (Basel, Switzerland) · 2026Article
- Combined Analysis by Peak and Submaximal Exercise Parameters Delineates Underlying Mechanisms of Poor Exercise Performance in Fontan Patients.Pediatric cardiology · 2026Article
- Exercise Capacity, Endothelial Function, Muscle Mass, and Strength in Pediatric Patients With Fontan Circulation.CJC pediatric and congenital heart disease · 2026Article
- NT-proBNP and other blood biomarkers in patients after Fontan Surgery: Prognostic, diagnostic, and management implications.International journal of cardiology. Congenital heart disease · 2026Article
- Phenotyping of Fontan-Associated Renal Physiology and Disease.Comprehensive Physiology · 2026Article
- Early Experience with the First Canadian Paediatric Fontan Long-Term Follow-up Clinic.Pediatric cardiology · 2026Article
- Augmenting Venous Return in Fontan Circulation: The Role of the Skeletal Muscle Pump and Implications for Mechanical Compression Devices-A Review of the Literature.Pediatric cardiology · 2026Review
- Predictive Role of Atrial Strain, Aortic Stiffness, and Muscle-Related Factors for Maximal and Submaximal Exercise Capacity in Fontan Patients.Pediatric cardiology · 2025Observational
- Interplay between Elevated Bile Acids and Reduced Vitamin D Levels in Fontan Circulation: A Double-Edged Sword.Current cardiology reports · 2025Review
- Circulating Biomarkers in Failing Fontan Circulation: Current Evidence and Future Directions.Journal of cardiovascular development and disease · 2025Review
- Efficacy of Magnetic Resonance Elastography in Fontan-Associated Liver Disease.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Systemic Changes in Adults With a Fontan Circulation: Insights From the Plasma Proteome.Journal of the American Heart Association · 2025Article
- Blood Biomarkers as a Non-Invasive Method for the Assessment of the State of the Fontan Circulation.Journal of clinical medicine · 2025Review
- Deterioration in Renal Function in Patients With a Fontan Circulation and Association With Mortality.JACC. Advances · 2024Article
- High-Performing Fontan Patients: A Fontan Outcome Registry by Cardiac Magnetic Resonance Imaging Study.JACC. Advances · 2024Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveWe sought to evaluate body composition in children and young adults with Fontan physiology. Leg lean mass (LM) deficits correlate with diminished exercise capacity in other populations and may contribute to exercise limitations in this cohort.
methodsThis cross-sectional study included whole body dual energy X-ray absorptiometry scans in 50 Fontan participants ≥5 years, and measures of peak oxygen consumption (VO2) in 28. Whole body and leg LM (a measure of skeletal muscle) were converted to sex- and race-specific Z-scores, relative to age and stature, based on 992 healthy reference participants.
resultsMedian age was 11.5 (range 5.1-33.5) years at 9.3 (1.1-26.7) years from Fontan. Height Z-scores were lower in Fontan compared with reference participants (-0.47±1.08 vs 0.25±0.93, p<0.0001). Body mass index Z-scores were similar (0.15±0.98 vs 0.35±1.02, p=0.18). LM Z-scores were lower in Fontan compared with reference participants (whole body LM -0.33±0.77 vs 0.00±0.74, p=0.003; leg LM -0.89±0.91 vs 0.00±0.89, p<0.0001). LM Z-scores were not associated with age or Fontan characteristics. Leg LM Z-scores were lower in vitamin D deficient versus sufficient Fontan participants (-1.47±0.63 vs -0.71±0.92, p=0.01). Median per cent predicted peak VO2 was 81% (range 13%-113%) and was associated with leg LM Z-scores (r=0.54, p=0.003).
conclusionsFollowing Fontan, children and young adults are shorter than their peers and have significant LM deficits. Skeletal muscle deficits were associated with vitamin D deficiency and reduced exercise capacity. Future studies should examine the progression of these deficits to further understand the contribution of peripheral musculature to Fontan exercise capacity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.