ArticleBone2015
Deficits in bone density and structure in children and young adults following Fontan palliation.
Article in Bone, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 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
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Somatic growth in single ventricle patients: A systematic review and meta-analysis.Acta paediatrica (Oslo, Norway : 1992) · 2023Pooled it
- Fontan Circulation Associated Organ Abnormalities Beyond the Heart, Lungs, Liver, and Gut: A Systematic Review.Frontiers in cardiovascular medicine · 2022Pooled it
- NT-proBNP and other blood biomarkers in patients after Fontan Surgery: Prognostic, diagnostic, and management implications.International journal of cardiology. Congenital heart disease · 2026Article
- The impact of psychosocial factors on secondary hyperparathyroidism and vitamin D deficiency in adults with congenital heart disease-the CHD-HYPER study.Frontiers in nutrition · 2026Article
- 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
- Blood Biomarkers as a Non-Invasive Method for the Assessment of the State of the Fontan Circulation.Journal of clinical medicine · 2025Review
- Surrogates of Muscle Mass on Cardiac MRI Correlate with Exercise Capacity in Patients with Fontan Circulation.Journal of clinical medicine · 2023Article
- Cell-based therapy to boost right ventricular function and cardiovascular performance in hypoplastic left heart syndrome: Current approaches and future directions.Seminars in perinatology · 2023Review
- Morphologic Mandibular Bone Changes on Panoramic Radiographs of Children and Adolescents with Congenital Heart Disease.Children (Basel, Switzerland) · 2023Article
- Evaluation of bone mineral density and bone turnover in children on anticoagulation.Frontiers in endocrinology · 2023Article
- Nutritional Management of Patients with Fontan Circulation: A Potential for Improved Outcomes from Birth to Adulthood.Nutrients · 2022Review
- A Path FORWARD: Development of a Comprehensive Multidisciplinary Clinic to Create Health and Wellness for the Child and Adolescent with a Fontan Circulation.Pediatric cardiology · 2022Review
- Deficits in the Functional Muscle-Bone Unit in Youths with Fontan Physiology.The Journal of pediatrics · 2021Article
- Longitudinal growth in patients with single ventricle cardiac disease receiving tube-assisted feeds.Congenital heart disease · 2019Article
- Increased Fracture Risk with Furosemide Use in Children with Congenital Heart Disease.The Journal of pediatrics · 2018Article
- Where Is the "Optimal" Fontan Hemodynamics?Korean circulation journal · 2017Review
- 30-year experience of Fontan surgery: single-centre's data.Journal of cardiothoracic surgery · 2017Article
- Hepatic Fibrosis Is Universal Following Fontan Operation, and Severity is Associated With Time From Surgery: A Liver Biopsy and Hemodynamic Study.Journal of the American Heart Association · 2017Article
- Relationship Between Habitual Exercise and Performance on Cardiopulmonary Exercise Testing Differs Between Children With Single and Biventricular Circulations.Pediatric cardiology · 2017Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSurvival of patients with congenital heart disease has improved such that there are now more adults than children living with these conditions. Complex single ventricle congenital heart disease requiring Fontan palliation is associated with multiple risk factors for impaired bone accrual. Bone density and structure have not been characterized in these patients.
methodsTibia peripheral quantitative computed tomography (pQCT) was used to assess trabecular and cortical volumetric bone mineral density (vBMD), cortical dimensions, and calf muscle area in 43 Fontan participants (5-33 years old), a median of 10 years following Fontan palliation. pQCT outcomes were converted to sex- and race-specific Z-scores relative to age based on >700 healthy reference participants. Cortical dimensions and muscle area were further adjusted for tibia length.
resultsHeight Z-scores were lower in Fontan compared to reference participants (mean ± SD: -0.29 ± 1.00 vs. 0.25 ± 0.93, p < 0.001); BMI Z-scores were similar (0.16 ± 0.88 vs. 0.35 ± 1.02, p = 0.1). Fontan participants had lower trabecular vBMD Z-scores (-0.85 ± 0.96 vs. 0.01 ± 1.02, p < 0.001); cortical vBMD Z-scores were similar (-0.17 ± 0.98 vs. 0.00 ± 1.00, p = 0.27). Cortical dimensions were reduced with lower cortical area (-0.59 ± 0.84 vs. 0.00 ± 0.88, p<0.001) and periosteal circumference (-0.50 ± 0.82 vs. 0.00 ± 0.84, p < 0.001) Z-scores, compared to reference participants. Calf muscle area Z-scores were lower in the Fontan participants (-0.45 ± 0.98 vs. 0.00 ± 0.96, p = 0.003) and lower calf muscle area Z-scores were associated with smaller periosteal circumference Z-scores (R = 0.62, p < 0.001). Musculoskeletal deficits were not associated with age, Fontan characteristics, parathyroid hormone or vitamin D levels.
conclusionsChildren and young adults demonstrate low trabecular vBMD, cortical structure and muscle area following Fontan. Muscle deficits were associated with smaller periosteal dimensions. Future studies should determine the fracture implications of these deficits and identify interventions to promote musculoskeletal development.
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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.