Body composition in patients with Fontan physiology: a systematic review

Area of Science:

• Cardiology
• Physiology
• Body Composition Analysis

Background:

• Fontan circulation presents a unique physiological state impacting multiple organ systems.
• Assessing body composition is crucial for evaluating the health status of Fontan patients.
• Previous research suggests a link between impaired exercise capacity in Fontan patients and body composition.

Approach:

• This systematic review analyzed 18 studies encompassing 774 Fontan patients.
• Body composition was assessed using methods including DXA, BIA, CT, and MRI.
• Data were collected for studies published up to April 2023.

Key Points:

• Fontan patients typically exhibit a normal body mass index (BMI) compared to healthy individuals.
• However, studies consistently reveal increased fat mass and decreased muscle/lean mass in Fontan patients.
• These body composition abnormalities correlate with diminished exercise capacity and cardiac function.

Conclusions:

• Fontan patients possess an unfavorable body composition characterized by elevated fat and reduced muscle mass, irrespective of normal BMI.
• This altered body composition is associated with adverse outcomes, including decreased exercise tolerance, impaired cardiac performance, and increased hospital admissions.
• Understanding these body composition changes is vital for managing Fontan circulation patients and improving their long-term health outcomes.