Evidence map›Paper›PMID 36796574›Full record

ArticleAmerican heart journal2023

Design and rationale of re-energize fontan: Randomized exercise intervention designed to maximize fitness in fontan patients.

Elif Seda Selamet Tierney, Latha Palaniappan, Mary Leonard, Jin Long, Jonathan Myers, Tania Dávila, Mavis C Lui, Feliks Kogan, Inger Olson, Rajesh Punn and 5 more

Open access · greenAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in American heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.1field-weighted citation impact, top 12% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. 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

15 authors at 5 institutions in 1 country.

Elif Seda Selamet TierneyDepartment of Pediatrics, Division of Pediatric Cardiology, Stanford University, School of Medicine, Palo Alto, CA, USA. Electronic address: tierneys@stanford.edu.
Latha PalaniappanDepartment of Medicine, Stanford University, School of Medicine, Palo Alto, CA, USA.
Mary LeonardDepartment of Pediatrics, Division of Pediatric Nephrology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Jin LongDepartment of Pediatrics, Division of Pediatric Nephrology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Jonathan MyersDepartment of Medicine, Health Research Science, Palo Alto VA Health Care System, Palo Alto, CA, USA.
Tania DávilaDepartment of Pediatrics, Division of Pediatric Cardiology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Mavis C LuiDepartment of Pediatrics, Division of Pediatric Cardiology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Feliks KoganDepartment of Radiology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Inger OlsonDepartment of Pediatrics, Division of Pediatric Cardiology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Rajesh PunnDepartment of Pediatrics, Division of Pediatric Cardiology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Manisha DesaiDepartment of Biomedical Data Science, Stanford University, School of Medicine, Palo Alto, CA, USA.
Lauren M SchneiderPsychiatry and Behavioral Sciences - Child & Adolescent Psychiatry and Child Development, Palo Alto, CA, USA.
Chih-Hung WangDepartment of Pediatrics, Health Policy, Stanford University, School of Medicine, Palo Alto, CA, USA.
John P CookeHouston Methodist Research Institute Houston Methodist Hospital & Research Institute, Houston, Texas, USA.
Daniel BernsteinDepartment of Pediatrics, Division of Pediatric Cardiology, Stanford University, School of Medicine, Palo Alto, CA, USA.
Stanford University · USAmerican Academy of Child and Adolescent Psychiatry · USHouston Methodist · USStanford Medicine · USVA Palo Alto Health Care System · US

Funding

RE-ENERGIZE FONTAN - RandomizEd Exercise INtERvention desiGned to MaximIZE Fitness in Pediatric FONTAN patientsR33HL146775 · NHLBI · STANFORD UNIVERSITY · PI BERNSTEIN, DANIEL, PALANIAPPAN, LATHA P · 2021 to 2024
$2.8M
META - Mentor, Educate, Train, Advocate: Patient Oriented Researchers in Cardiometabolic DiseaseK24HL150476 · NHLBI · STANFORD UNIVERSITY · PI Latha P Palaniappan · 2020 to 2026
$846k
RE-ENERGIZE FONTAN - RandomizEd Exercise INtERvention desiGned to MaximIZE Fitness in Pediatric FONTAN patientsR61HL146775 · NHLBI · STANFORD UNIVERSITY · PI BERNSTEIN, DANIEL, PALANIAPPAN, LATHA P · 2020 to 2020
$753k
NHLBI NIH HHS K24 HL150476NHLBI NIH HHS R33 HL146775NHLBI NIH HHS R61 HL146775
6 · The paper itself

Abstract

In this manuscript, we describe the design and rationale of a randomized controlled trial in pediatric Fontan patients to test the hypothesis that a live-video-supervised exercise (aerobic+resistance) intervention will improve cardiac and physical capacity; muscle mass, strength, and function; and endothelial function. Survival of children with single ventricles beyond the neonatal period has increased dramatically with the staged Fontan palliation. Yet, long-term morbidity remains high. By age 40, 50% of Fontan patients will have died or undergone heart transplantation. Factors that contribute to onset and progression of heart failure in Fontan patients remain incompletely understood. However, it is established that Fontan patients have poor exercise capacity which is associated with a greater risk of morbidity and mortality. Furthermore, decreased muscle mass, abnormal muscle function, and endothelial dysfunction in this patient population is known to contribute to disease progression. In adult patients with 2 ventricles and heart failure, reduced exercise capacity, muscle mass, and muscle strength are powerful predictors of poor outcomes, and exercise interventions can not only improve exercise capacity and muscle mass, but also reverse endothelial dysfunction. Despite these known benefits of exercise, pediatric Fontan patients do not exercise routinely due to their chronic condition, perceived restrictions to exercise, and parental overprotection. Limited exercise interventions in children with congenital heart disease have demonstrated that exercise is safe and effective; however, these studies have been conducted in small, heterogeneous groups, and most had few Fontan patients. Critically, adherence is a major limitation in pediatric exercise interventions delivered on-site, with adherence rates as low as 10%, due to distance from site, transportation difficulties, and missed school or workdays. To overcome these challenges, we utilize live-video conferencing to deliver the supervised exercise sessions. Our multidisciplinary team of experts will assess the effectiveness of a live-video-supervised exercise intervention, rigorously designed to maximize adherence, and improve key and novel measures of health in pediatric Fontan patients associated with poor long-term outcomes. Our ultimate goal is the translation of this model to clinical application as an "exercise prescription" to intervene early in pediatric Fontan patients and decrease long-term morbidity and mortality.

Indexed as

Fontan ProcedureHeart Defects, CongenitalHeart FailureHeart TransplantationAdultChildExerciseExercise TestExercise TherapyHumansInfant, NewbornMuscle StrengthRandomized Controlled Trials as Topic

Identifiers

PMID36796574
PMCPMC10085861
OpenAlexW4320718683

What OpenQuestion holds

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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.