High-Performing Fontan Patients
Tarek Alsaied, Runjia Li, Adam Christopher, Mark A. Fogel, Timothy C. Slesnick, Rajesh Krishnamurthy, Vivek Muthurangu, Adam L. Dorfman, Christopher Z. Lam, Justin Weigand, Joshua D. Robinson, Rachael Cordina, Laura Olivieri, Rahul H. Rathod, Yue-Hin Loke, Kenan Stern, Jonathan H. Soslow, Thomas P. Graham, Manish Aggarwal, Tiffanie Johnson, Markus Renno, Amee Shah, Michael Quail, Shelby Kutty, Helen Taussig, Ruchira Garg, Jeremy Steele, Pierangelo Renella, Madhuradhar Chegondi, Aswathy Vaikom House, Alison Marsden, Francesca Raimondi, Matthew D. Files
Abstract
Background: Fontan patients exhibit decreased exercise capacity. However, there is a subset of high-performing Fontan (HPF) patients with excellent exercise capacity. Objectives: tool using exercise data; 2) examine clinical factors associated with HPF patients; and 3) examine late outcomes in HPF patients. Methods: quartile. Multivariable logistic regression was employed to investigate factors associated with the HPF and Cox regression was used to examine the association between HPF patients and late outcomes (composite of death or listing for cardiac transplant). Results: = 0.01). Patients with at least moderate atrioventricular valve regurgitation, protein-losing enteropathy, or who were using psychiatric medications, were less likely to be an HPF patient. After a mean follow-up of 3.7 years, 46 (5.7%) patients developed a composite endpoint. HPF had a lower risk of death or listing for cardiac transplant (HR: 0.06 [95% CI: 0.01-0.25]). Conclusions: Patients with HPF have more favorable outcomes when compared to patients with lower exercise capacity. This large registry data highlights the role of exercise testing in providing personalized care and surveillance post-Fontan.