Freud Lindsay R, Webster Gregory, Costello John M, Tsao Sabrina, Rychlik Karen, Backer Carl L, Deal Barbara J
Department of Pediatrics, Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
Department of Pediatrics, Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
World J Pediatr Congenit Heart Surg. 2015 Oct;6(4):514-20. doi: 10.1177/2150135115598212.
Long-term growth outcomes and the prevalence of obesity among older single ventricle (SV) patients have not been well characterized. We investigated these parameters, as well as the impact of obesity on survival, in an older cohort of SV patients presenting for Fontan conversion.
We analyzed preoperative height, weight, and body mass index (BMI) of patients who underwent Fontan conversion. Overweight and obese were defined as BMI ≥85 percentile and ≥95 percentile for patients <20 years and BMI 25 to 30 kg/m(2) and ≥30 kg/m(2) for patients ≥20 years, respectively. Postoperative transplant-free survival was assessed among obese, overweight, and normal weight patients.
We evaluated 139 patients presenting for Fontan conversion at a median age of 23.2 years. Patients had shorter stature compared to the normal population (mean Z score -0.6, P < .001). Younger patients had lower BMI compared to the normal population (<20 years: mean Z score -0.5, P = .02), while older patients had elevated BMI (≥20 years: mean Z score +0.4, P < .001). The mean BMI among older patients approached overweight at 24.6 kg/m(2). The prevalence of obesity increased with advancing age, with 36% overweight and 14% obese at >30 years. At a median of 8.2 years following Fontan conversion, obesity and overweight status were not associated with transplant-free survival.
Older SV patients presenting for Fontan conversion had shorter stature compared to the normal population as well as a high prevalence of overweight and obesity. Although there was no relationship between weight status and early postoperative survival, further investigation of long-term outcomes is warranted.
大龄单心室（SV）患者的长期生长结局及肥胖患病率尚未得到充分描述。我们在一组接受Fontan转换术的大龄SV患者中，对这些参数以及肥胖对生存的影响进行了调查。
我们分析了接受Fontan转换术患者的术前身高、体重和体重指数（BMI）。超重和肥胖分别定义为：年龄<20岁的患者，BMI≥第85百分位数和≥第95百分位数；年龄≥20岁的患者，BMI为25至30 kg/m²和≥30 kg/m²。评估肥胖、超重和正常体重患者术后的无移植生存率。
我们评估了139例接受Fontan转换术的患者，中位年龄为23.2岁。与正常人群相比，这些患者身材较矮（平均Z评分-0.6，P<.001）。较年轻患者的BMI低于正常人群（<20岁：平均Z评分-0.5，P=.02），而较年长患者的BMI升高（≥20岁：平均Z评分+0.4，P<.001）。大龄患者的平均BMI接近超重，为24.6 kg/m²。肥胖患病率随年龄增长而增加，>30岁时超重者占36%，肥胖者占14%。在Fontan转换术后中位8.2年时，肥胖和超重状态与无移植生存率无关。
与正常人群相比，接受Fontan转换术的大龄SV患者身材较矮，超重和肥胖患病率较高。尽管体重状态与术后早期生存之间没有关系，但仍有必要对长期结局进行进一步调查。
