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- Title
Early characteristics of bone deficits in children with Fontan palliation.
- Authors
Sarafoglou, Kyriakie; Petryk, Anna; Mishra, Pooja E; Polgreen, Lynda E; Panoskaltsis-Mortari, Angela; Brown, Roland; Marino, Bradley S; Gremmels, David; Shepard, Charles; Kelly, Aaron S; Miller, Bradley S; Rudser, Kyle; McCracken, Courtney; Kochilas, Lazaros K
- Abstract
<bold>Background: </bold>This is a cross-sectional study aiming to understand the early characteristics and background of bone health impairment in clinically well children with Fontan circulation.<bold>Methods: </bold>We enrolled 10 clinically well children with Fontan palliation (operated >5 years before study entrance, Tanner stage ≤3, age 12.1 ± 1.77 years, 7 males) and 11 healthy controls (age 12.0 ± 1.45 years, 9 males) at two children's hospitals. All patients underwent peripheral quantitative CT. For the Fontan group, we obtained clinical characteristics, NYHA class, cardiac index by MRI, dual x-ray absorptiometry, and biochemical studies. Linear regression was used to compare radius and tibia peripheral quantitative CT measures between Fontan patients and controls.<bold>Results: </bold>All Fontan patients were clinically well (NYHA class 1 or 2, cardiac index 4.85 ± 1.51 L/min/m2) and without significant comorbidities. Adjusted trabecular bone mineral density, cortical thickness, and bone strength index at the radius were significantly decreased in Fontan patients compared to controls with mean differences -30.13 mg/cm3 (p = 0.041), -0.31 mm (p = 0.043), and -6.65 mg2/mm4 (p = 0.036), respectively. No differences were found for tibial measures. In Fontan patients, the mean height-adjusted lumbar bone mineral density and total body less head z scores were -0.46 ± 1.1 and -0.63 ± 1.1, respectively, which are below the average, but within normal range for age and sex.<bold>Conclusions: </bold>In a clinically well Fontan cohort, we found significant bone deficits by peripheral quantitative CT in the radius but not the tibia, suggesting non-weight-bearing bones may be more vulnerable to the unique haemodynamics of the Fontan circulation.
- Subjects
CONGENITAL heart disease diagnosis; BONE metabolism; PHOTON absorptiometry; BONES; OSTEOPENIA; CROSS-sectional method; CONGENITAL heart disease; MAGNETIC resonance imaging; CARDIOPULMONARY bypass; BONE density; COMPUTED tomography
- Publication
Cardiology in the Young, 2020, Vol 30, Issue 4, p468
- ISSN
1047-9511
- Publication type
journal article
- DOI
10.1017/S1047951120000293