Evidence map›Paper›PMID 36048833›Full record

ArticlePloS one2022

Orthostatic stress response in pediatric Fontan patients and the effect of ACE inhibition.

Lisette M Harteveld, Nico A Blom, J Gert van Dijk, Robert H Reijntjes, Paul J van Someren, Fabian I Kerkhof, Irene M Kuipers, Lukas A J Rammeloo, Eco J C de Geus, Arend D J Ten Harkel

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Lisette M HarteveldThe Center for Congenital Heart Disease Amsterdam-Leiden, Leiden, The Netherlands.ORCID 0000-0002-1930-013X
Nico A BlomThe Center for Congenital Heart Disease Amsterdam-Leiden, Leiden, The Netherlands.
J Gert van DijkDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands.
Robert H ReijntjesDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-7784-1807
Paul J van SomerenDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands.
Fabian I KerkhofDepartment of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-8588-3273
Irene M KuipersThe Center for Congenital Heart Disease Amsterdam-Leiden, Leiden, The Netherlands.
Lukas A J RammelooThe Center for Congenital Heart Disease Amsterdam-Leiden, Leiden, The Netherlands.
Eco J C de GeusDepartment of Biological Psychology, Faculty of Human Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0001-6022-2666
Arend D J Ten HarkelThe Center for Congenital Heart Disease Amsterdam-Leiden, Leiden, The Netherlands.
Leiden University · NLLeiden University Medical Center · NLVrije Universiteit Amsterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany cardiocirculatory mechanisms are involved in the adaptation to orthostatic stress. While these mechanisms may be impaired in Fontan patients. However, it is yet unclear how Fontan patients, who exhibit a critical fluid balance, respond to orthostatic stress. Angiotensin converting enzyme inhibitors are often prescribed to Fontan patients, but they may negatively influence orthostatic tolerance. Therefore, we evaluated the response to orthostatic stress in pediatric Fontan patients before and after treatment with enalapril.

methodsThirty-five Fontan patients (aged 14 years) with moderate-good systolic ventricular function without pre-existent enalapril treatment were included. Before and after a three-month enalapril treatment period, the hemodynamic response to head-up tilt test was evaluated by various parameters including cardiac index, blood pressure, cerebral blood flow, aortic stiffness and cardiac autonomous nervous activity. Thirty-four healthy subjects (aged 13 years) served as controls.

resultsFontan patients had a decreased cerebral blood flow and increased aortic stiffness in the supine position compared to controls, while all other factors did not differ. Patients and controls showed a comparable response to head-up tilt test for most parameters. Twenty-seven patients completed the enalapril study with a mean dosage of 0.3±0.1mg/kg/day. Most parameters were unaffected by enalapril, only the percent decrease in cardiac index to tilt was higher after treatment, but the cardiac index during tilt was not lower (3.0L/min/m2 pre-enalapril versus 2.8L/min/m2 after treatment; P = 0.15).

conclusionPediatric Fontan patients adequately respond to orthostasis with maintenance of blood pressure and cerebral blood flow and sufficient autonomic response. Enalapril treatment did not alter the response. CLINICAL TRIAL INFORMATION: Scientific title: ACE inhibition in Fontan patients: its effect on body fluid regulation (sAFE-study). The Netherlands National Trial Register: Trail NL6415. Registered 2017-07-20. Trial information: https://www.trialregister.nl/trial/6415.

Indexed as

Angiotensin-Converting Enzyme InhibitorsEnalaprilBlood PressureChildHemodynamicsHumansTilt-Table TestAngiotensin-Converting Enzyme InhibitorsEnalapril

Identifiers

PMID36048833
PMCPMC9436155
OpenAlexW4294044656

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.