Abstract:
BACKGROUND:Non-cardiac complications, such as hepato-renal and metabolic problems, are emerging late after the Fontan operation due to its unique hemodynamics. Consequently, associations between clinical variables and postoperative outcome may change during the prolonged postoperative course. METHODS AND RESULTS:To determine if child and adult Fontan patients differ in the impact of cardiac and non-cardiac variables on clinical outcome, we prospectively evaluated associations between hemodynamics, neurohumoral factors, exercise variables, hepato-renal function and metabolic variables and unscheduled hospitalization, including death in 167 consecutive child and 116 adult Fontan patients. When compared with child patients, the adult patients showed higher rates of medications, lower cardiac index, higher values of natriuretic peptides, greater renal dysfunction, more cholestatic livers, and more impaired responses to exercise (p<0.05-0.0001). During the follow-up of 3.7 ± 2.1 years, 64 clinical events (37 in adults), including 13 deaths, occurred. A high CVP and low arterial oxygen satutration strongly predicted the child events (p<0.001), whereas these prognostic parameters were marginal in the adults. Instead, renal dysfunction and metabolic abnormality predicted adult events (p<0.05). Neurohumoral activation, low albumin, hyponatremia, and impaired exercise variables equally predicted clinical events in child and adult Fontan patients. CONCLUSIONS:Distinctive differences in predictive value of clinical variables exist between child and adult Fontan patients. In addition to cardiac issues, we should consider non-cardiac determinents of clinical outcome to maximize our efforts to improve prognosis for adult Fontan survivors.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Ohuchi H,Yasuda K,Miyazaki A,Iwasa T,Sakaguchi H,Shin O,Mizuno M,Negishi J,Noritake K,Yamada Odoi
10.1016/j.ijcard.2014.03.001subject
Has Abstractpub_date
2014-05-01 00:00:00pages
277-83issue
2eissn
0167-5273issn
1874-1754pii
S0167-5273(14)00425-2journal_volume
173pub_type
杂志文章abstract:BACKGROUND:Sleep disordered breathing, especially obstructive sleep apnea, is associated with endothelial dysfunction in both adults and children. However, the role of primary snoring (PS) on endothelial function has not been investigated. This study aimed to examine flow-mediated vasodilation (FMD) in both normal weig...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2012.05.108
更新日期:2013-09-01 00:00:00
abstract::This report describes a 61-year-old female with an anomalous drainage of the right superior vena cava into the left atrium. The patient presented progressively severe dyspnea and precordial pain on exertion, lightheadedness, easy fatiguability and a constant decline in her performance but normal cardiac and pulmonary ...
journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/s0167-5273(98)00054-0
更新日期:1998-05-15 00:00:00
abstract:BACKGROUND:There is no literature evaluating the effect of exercise on patients with aortic stenosis, in which patients with and without coronary artery disease were assessed separately. OBJECTIVE:To assess the effects of isometric exercise on the diastolic function in patients with aortic stenosis (AS). METHODS:18 p...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2004.10.014
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abstract:BACKGROUND:Sleep disordered breathing (SDB) is common in patients with heart failure with reduced ejection fraction (HFrEF). An increased apnea-hypopnea index (AHI) is associated with poor outcomes. We examined whether an analysis of nocturnal desaturations (NDs) can improve the risk stratification. METHODS:Three-hund...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2015.11.108
更新日期:2016-01-15 00:00:00
abstract::Chronic sickle cell (SC) disease is known to cause pulmonary hypertension (PH) which eventually affects right as well as left ventricular function. However, the acute effects of SC crisis on right ventricular (RV) function in adults have not been well described. Our echocardiography database was queried for patients f...
journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2007.08.099
更新日期:2009-03-06 00:00:00
abstract::We studied haemodynamic changes during dobutamine stress echocardiography in 69 patients (mean age 58 years, 6 female, 63 male) referred for investigation of chest pain. We used a standard protocol of 3 min stages using infusion rates of 5, 10, 20, 30 and 40 micrograms/kg/min. Heart rate rose from 74 (13) to 123 (21) ...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/s0167-5273(96)02846-x
更新日期:1997-01-03 00:00:00
abstract::A 25-year-old man with massive pericardial effusion is presented. The high lymphocyte amount and cytological analysis of the aspirated fluid suggested tuberculous or malignant pericarditis. The chylous nature of the effusion was only recognized after hemipericardiectomy, when reaccumulation of fluid into the pleural s...
journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:1987-01-01 00:00:00
abstract:PURPOSE:Pre and post-operative administration of sevoflurane in myocardial revascularization surgery provides enhanced cardioprotective effects exerted by pharmacologic pre- and post-conditioning, as compared to propofol. The identification of the enzymes involved in conditioning mechanisms is crucial to the understand...
journal_title:International journal of cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijcard.2017.04.105
更新日期:2017-09-15 00:00:00
abstract:BACKGROUND:Left bundle branch block (LBBB) negatively affects prognosis in heart failure patients with a reduced left ventricular ejection fraction (LVEF). Less is known about the prognostic role of LBBB in dilated cardiomyopathy (DCM) with intermediate LVEF (between 36% and 50%). We sought to assess the role of LBBB i...
journal_title:International journal of cardiology
pub_type: 杂志文章
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更新日期:2019-03-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2007.04.106
更新日期:2008-04-10 00:00:00
abstract::We studied 36 patients with successful transluminal coronary angioplasty (group 1) noninvasively using exercise electrocardiography, exercise T1-201 myocardial scintigraphy and equilibrium radionuclide ventriculography before and 3-5 days after the procedure. Six patients who underwent aortocoronary-bypass surgery (gr...
journal_title:International journal of cardiology
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abstract:BACKGROUND:There is a controversy surrounding the correlation between fibrinogen (Fib) level and prognosis of coronary artery disease (CAD). We try to investigate the role of the subtypes of CAD in this controversy. METHODS:A retrospective analysis was conducted from a single center CAD registered database. 3020 conse...
journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2016.07.160
更新日期:2016-11-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(94)90091-4
更新日期:1994-01-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2007.11.094
更新日期:2008-04-10 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ijcard.2018.01.054
更新日期:2018-06-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2017.11.024
更新日期:2018-02-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2006.08.012
更新日期:2007-09-03 00:00:00
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journal_title:International journal of cardiology
pub_type: 信件
doi:10.1016/j.ijcard.2005.02.026
更新日期:2006-03-22 00:00:00
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journal_title:International journal of cardiology
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pub_type: 信件
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journal_title:International journal of cardiology
pub_type: 信件
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更新日期:2007-05-02 00:00:00
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pub_type: 杂志文章
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更新日期:2020-05-15 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.ijcard.2016.11.086
更新日期:2017-02-01 00:00:00
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/0167-5273(89)90252-0
更新日期:1989-05-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2004.02.015
更新日期:2005-03-30 00:00:00
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journal_title:International journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.ijcard.2003.07.034
更新日期:2004-10-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1986-06-01 00:00:00
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journal_title:International journal of cardiology
pub_type: 评论,历史文章,信件
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更新日期:2009-08-14 00:00:00
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pub_type: 杂志文章
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