1. Iron deficiency in patients with a Fontan circulation and its impact on exercise capacity.
- Author
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van Hassel G, Rivrud SCS, Timmerman FJ, van der Meer P, Hoendermis ES, Liem ET, Berger RMF, and van Melle JP
- Subjects
- Humans, Female, Male, Adult, Prevalence, Young Adult, Biomarkers blood, Anemia, Iron-Deficiency blood, Anemia, Iron-Deficiency epidemiology, Anemia, Iron-Deficiency diagnosis, Anemia, Iron-Deficiency physiopathology, Oxygen Consumption physiology, Iron blood, Iron Deficiencies, Adolescent, Ferritins blood, Fontan Procedure adverse effects, Heart Defects, Congenital surgery, Heart Defects, Congenital blood, Heart Defects, Congenital physiopathology, Heart Defects, Congenital epidemiology, Exercise Tolerance physiology, Exercise Test
- Abstract
Background: Iron deficiency (ID) has been reported in patients with congenital heart disease. There is, however, a scarcity of data on its prevalence in patients with a Fontan circulation. The aim of this study is to investigate the prevalence of ID in Fontan patients and to investigate the association between ID and exercise capacity in this population., Methods and Results: Blood count and haematological parameters were determined in plasma of 61 Fontan patients (51% female, mean age 29±9 years). ID was defined as transferrin saturation (TSAT) ≤19.8%. The prevalence of ID was 36% (22/61 patients). Especially among women, the diagnosis of ID was highly prevalent (52%) despite normal haemoglobin levels (153.7±18.4 g/L). Mean ferritin levels were 98±80 µg/L and mean TSAT levels were 22%±12%. Cardiopulmonary exercise testing was performed in 46 patients (75%). Patients with ID had a lower peak oxygen uptake (V̇O
2 peak) (1397±477 vs 1692±530 mL/min; p=0.039), although this relationship was confounded by sex. The presence of ID increased the likelihood of not achieving a respiratory exchange ratio (RER) ≥1.1 by 5-fold (p=0.035)., Conclusion: ID is highly prevalent among patients with a Fontan circulation. V̇O2 peak is lower in patients with ID. Fontan patients with ID are less likely to achieve an RER≥1.1 during cardiopulmonary exercise testing., Competing Interests: Competing interests: RMFB: The University Medical Center Groningen contracts with Janssen, MSD and GSK for steering committee and advisory board committee activities of RMFB, outside the scope of this manuscript., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2024
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