International Journal of Cardiovascular Sciences. 11/Apr/2022;35(5):618-24.
Cardiovascular Risk Factors in Children and Adolescents with Fontan Circulation
Sandra Mari Barbiero
, Rafael B. Carloto
, Danielly Steffen Pereira
, Gabriela C. Schwantes
, Marcela Menuci Guimarães
, Maíra Ribas Goulart
, Daniela Schneid Schuh
, Lucia Campos Pellanda
Abstract
Background:
Long-term outcomes of patients with Fontan circulation are uncertain regarding the prevalence and role of risk factors (RFs) such as increased body mass index (BMI), arterial hypertension, and hypercholesterolemia.
Objectives:
To describe the prevalence of RFs in patients with univentricular heart, with variable follow-up times.
Methods:
This mixed cohort study was performed with 66 patients, who underwent blood count, fasting blood glucose, C-reactive protein (CRP), and lipid profile tests; systolic/diastolic blood pressure (SBP/DBP) measurements; and anthropometric and sociodemographic data collection. Cardiovascular RFs among first-degree relatives and physical activity habits were also assessed. Prevalence was described using proportions, with a 95% confidence interval. Continuous variables (height, weight, age, SBP, DBP) were described as means and standard deviations (m±SD). Associations between RFs were assessed using chi-squared or Fisher’s exact tests. Spearman’s correlation was used for analyzing CRP and the presence of 2 or more RFs. The Shapiro-Wilk test was used to check for data normality. Statistical significance considered p<0.05.
Results:
In our population, 19.7% were overweight, mean SBP was 89.44±37.4, and mean DBP was 60.0±26.08. The most prevalent diseases in the interviewees’ families were systemic arterial hypertension (30.3%), obesity (16.7%), and 2 or more cardiovascular RFs among first-degree relatives (13.8%). We observed a trend towards significance between the presence of 2 familial RFs and overweight, as well as a risk profile for cardiovascular disease. There was an association between the BMI percentile, the presence of 2 or more RFs (p<0.05), and CRP (p<0.01).
Conclusions:
Overweight is common in patients with univentricular heart, being related to more than 2 cardiovascular RFs among first-degree relatives; physical inactivity and changes in lipid profiles are also frequent.
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