Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation

Background: This study aims to assess sex differences with regards to outcome, cardiovascular dimensions, and functional capacity in patients with a Fontan circulation. Methods: In this single-center prospective, standardised cohort study of 60 Fontan patients (30 females, 50%) aged ≥10 years, the a...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sophie L. Meyer, Djoeke Wolff, Floris-Jan S. Ridderbos, Quint A.J. Hagdorn, Graziella Eshuis, Joost P. van Melle, Tjark Ebels, Tineke P. Willems, Rolf M.F. Berger
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Fontan circulation Functionally univentricular heart Sex differences Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/1750974149c3427f8f0f1623a86beb4d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:1750974149c3427f8f0f1623a86beb4d
record_format	dspace
spelling	oai:doaj.org-article:1750974149c3427f8f0f1623a86beb4d2021-11-06T04:37:09ZSex differences in cardiac function and clinical outcome in patients with a Fontan circulation2666-668510.1016/j.ijcchd.2021.100197https://doaj.org/article/1750974149c3427f8f0f1623a86beb4d2021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S266666852100121Xhttps://doaj.org/toc/2666-6685Background: This study aims to assess sex differences with regards to outcome, cardiovascular dimensions, and functional capacity in patients with a Fontan circulation. Methods: In this single-center prospective, standardised cohort study of 60 Fontan patients (30 females, 50%) aged ≥10 years, the association between sex and the combined outcome variable of all-cause mortality, heart/heart-lung transplantation (including listing) and Fontan-related hospitalisation was investigated. Secondary outcome measures included functional capacity and ventricular dimensions, measured by cardiac magnetic resonance imaging (CMR), cardiopulmonary exercise testing (CPET) and concomitant clinical assessment. Results: Baseline characteristics including age, diagnosis and surgical history did not differ between female and male patients. During a median follow-up time of 5.75 (5.4–6.0) years, the combined outcome variable occurred in 17 (28%) patients. Female Fontan patients had 13 (43%) adverse events and males 4 (13%). Event-free survival differed significantly (p = 0.040). At baseline, the majority of males was in NYHA class I (n = 19, 63%), whereas the majority of females was in NYHA class II or III (n = 20, 67%) (p = 0.036). Male Fontan patients had about 25% higher end-diastolic volume (p = 0.001) indexed for body surface area (BSA), 28% higher indexed end-systolic volume (p = 0.004) and 25% more indexed ventricular mass (p < 0.001). Conclusions: In Fontan patients, event-free survival is significantly higher in males compared to females. Relevant sex differences in ventricular dimensions as well as functional capacity exist, which exceed the differences seen in the healthy population. These differences should be considered when analysing and interpreting cut-off values to improve risk stratification.Sophie L. MeyerDjoeke WolffFloris-Jan S. RidderbosQuint A.J. HagdornGraziella EshuisJoost P. van MelleTjark EbelsTineke P. WillemsRolf M.F. BergerElsevierarticleFontan circulationFunctionally univentricular heartSex differencesDiseases of the circulatory (Cardiovascular) systemRC666-701ENInternational Journal of Cardiology Congenital Heart Disease, Vol 5, Iss , Pp 100197- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fontan circulation Functionally univentricular heart Sex differences Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Fontan circulation Functionally univentricular heart Sex differences Diseases of the circulatory (Cardiovascular) system RC666-701 Sophie L. Meyer Djoeke Wolff Floris-Jan S. Ridderbos Quint A.J. Hagdorn Graziella Eshuis Joost P. van Melle Tjark Ebels Tineke P. Willems Rolf M.F. Berger Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation
description	Background: This study aims to assess sex differences with regards to outcome, cardiovascular dimensions, and functional capacity in patients with a Fontan circulation. Methods: In this single-center prospective, standardised cohort study of 60 Fontan patients (30 females, 50%) aged ≥10 years, the association between sex and the combined outcome variable of all-cause mortality, heart/heart-lung transplantation (including listing) and Fontan-related hospitalisation was investigated. Secondary outcome measures included functional capacity and ventricular dimensions, measured by cardiac magnetic resonance imaging (CMR), cardiopulmonary exercise testing (CPET) and concomitant clinical assessment. Results: Baseline characteristics including age, diagnosis and surgical history did not differ between female and male patients. During a median follow-up time of 5.75 (5.4–6.0) years, the combined outcome variable occurred in 17 (28%) patients. Female Fontan patients had 13 (43%) adverse events and males 4 (13%). Event-free survival differed significantly (p = 0.040). At baseline, the majority of males was in NYHA class I (n = 19, 63%), whereas the majority of females was in NYHA class II or III (n = 20, 67%) (p = 0.036). Male Fontan patients had about 25% higher end-diastolic volume (p = 0.001) indexed for body surface area (BSA), 28% higher indexed end-systolic volume (p = 0.004) and 25% more indexed ventricular mass (p < 0.001). Conclusions: In Fontan patients, event-free survival is significantly higher in males compared to females. Relevant sex differences in ventricular dimensions as well as functional capacity exist, which exceed the differences seen in the healthy population. These differences should be considered when analysing and interpreting cut-off values to improve risk stratification.
format	article
author	Sophie L. Meyer Djoeke Wolff Floris-Jan S. Ridderbos Quint A.J. Hagdorn Graziella Eshuis Joost P. van Melle Tjark Ebels Tineke P. Willems Rolf M.F. Berger
author_facet	Sophie L. Meyer Djoeke Wolff Floris-Jan S. Ridderbos Quint A.J. Hagdorn Graziella Eshuis Joost P. van Melle Tjark Ebels Tineke P. Willems Rolf M.F. Berger
author_sort	Sophie L. Meyer
title	Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation
title_short	Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation
title_full	Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation
title_fullStr	Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation
title_full_unstemmed	Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation
title_sort	sex differences in cardiac function and clinical outcome in patients with a fontan circulation
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/1750974149c3427f8f0f1623a86beb4d
work_keys_str_mv	AT sophielmeyer sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT djoekewolff sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT florisjansridderbos sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT quintajhagdorn sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT graziellaeshuis sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT joostpvanmelle sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT tjarkebels sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT tinekepwillems sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation AT rolfmfberger sexdifferencesincardiacfunctionandclinicaloutcomeinpatientswithafontancirculation
_version_	1718443837979885568

Sex differences in cardiac function and clinical outcome in patients with a Fontan circulation

Ejemplares similares