Abstract 16480: Factors That Affect Activity Energy Expenditure of Fontan Patients
Background: There is a general trend favoring the recommendation of adequate exercise for Fontan patients. However, its effect on hemodynamics and safety have yet to be clarified. It is clearly very important to ascertain how the daily activity amount and activity intensity are associated with hemodynamics in Fontan patients.
Objectives: This study aimed to measure activity energy expenditure (AEE) and activity intensity in Fontan patients and examine their associations with hemodynamics.
Method: In total, 41 Fontan patients (3.5 to 42.3 years of age; mean, 9.6 years) were fitted with a high-accuracy portable accelerometer for 2 consecutive weeks and AEE was calculated and compared with the values of hemodynamics parameters obtained by cardiac catheterization.
Results: AEE in Fontan patients was 237 ± 95 kcal/day, showing a negative correlation with heart rate (HR; 84.7 ± 17.4 bpm, p<0.01) and positive correlations with cardiac output (CO; 2.9 ± 0.9 L/min, p<0.05) and stroke volume (SV; 36.0 ± 16.2 mL) (p <0.01). AEE also showed significant correlations (HR, p<0.01; SV, p = 0.01) in a multivariate analysis adjusted for age. These parameters showed stronger correlations when activity was light (1.0 to 3.0 Mets), which accounts for approximately 70% of the time in daily AEE (HR, p<0.01; SV, p<0.01). Meanwhile, AEE did not correlate with central venous pressure (CVP), pulmonary to systemic flow (Qp/Qs) ratio, pulmonary vascular resistance (Rp), or SpO2. Furthermore, as compared with CO values, the γ-GTP level, an indicator of hepatic congestion detected by blood testing, was significantly higher (63.9 ± 28.1 vs. 40.4 ± 27.6, p<0.05) in those with high AEE values than in other patients.
Conclusion: Our results suggest that the amount of daily activity in Fontan patients may be primarily affected by HR and SV. Also, high activity not corresponding to CO may lead to exacerbation of liver dysfunction.
Author Disclosures: A. Yana: None.
- © 2016 by American Heart Association, Inc.