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Pharmacology Management in Improving Exercise Capacity of Patients with Fontan Circulation: A Systematic Review and

Brian Mendel1,2, Christianto1, Moira Setiawan1

  • 1Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Current Cardiology Reviews
|April 5, 2022
PubMed

Insights

Bosentan treatment may improve exercise capacity in Fontan procedure patients by enhancing functional class and reducing heart rate. Further research is needed to fully understand its benefits for these patients.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Clinical Pharmacology

Background:

  • The Fontan procedure is a critical intervention for single ventricle physiology.
  • Long-term complications of the Fontan procedure significantly impact patient quality of life.
  • Improving exercise capacity is a key goal for managing Fontan patients.

Approach:

  • A meta-analysis was conducted following PRISMA guidelines.
  • Included studies were assessed for quality using the STROBE statement.
  • Effectiveness of pharmacologic agents on exercise capacity in Fontan circulation was compared.

Key Points:

  • Bosentan treatment significantly improved New York Heart Association Functional Class (NYHA FC) in Fontan patients.
  • Neither bosentan nor sildenafil showed significant improvement in maximal oxygen consumption (VO2 max).
  • Bosentan decreased post-exercise heart rate and improved 6-minute walking test results.

Conclusions:

  • Bosentan may offer benefits for Fontan circulation patients, indirectly enhancing exercise capacity.
  • Improvements include better NYHA FC and 6-minute walking test performance.
  • More research is necessary to optimize exercise capacity in Fontan patients.
Abstract

Keywords:
BosentanFontanexercise capacitypatientssildenafilvasodilator

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