Related Experiment Video

Updated: Jun 24, 2025

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise
07:09

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise

Published on: February 20, 2017

13.1K

Iron deficiency in patients with a Fontan circulation and its impact on exercise capacity

Gaston van Hassel1, Sean C S Rivrud2, Frank J Timmerman2

  • 1Center for Congential Heart Diseases, Department of Paediatric Cardiology, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands g.van.hassel@umcg.nl.

Open Heart
|June 5, 2024
PubMed

Insights

Iron deficiency (ID) is common in Fontan circulation patients, affecting 36%. This condition is linked to reduced exercise capacity, with lower peak oxygen uptake (V̇O2peak) and a decreased likelihood of achieving a respiratory exchange ratio (RER) ≥1.1.

Area of Science:

  • Cardiology
  • Hematology
  • Exercise Physiology

Background:

  • Iron deficiency (ID) is recognized in congenital heart disease patients.
  • Data on ID prevalence in Fontan circulation is limited.
  • This study addresses the prevalence of ID and its impact on exercise capacity in Fontan patients.

Purpose of the Study:

  • To determine the prevalence of iron deficiency in patients with Fontan circulation.
  • To assess the association between iron deficiency and exercise capacity in this population.

Main Methods:

  • Evaluated 61 Fontan patients (51% female, mean age 29±9 years).
  • Defined ID using transferrin saturation (TSAT) ≤19.8%.
  • Assessed exercise capacity via cardiopulmonary exercise testing in 46 patients.

Main Results:

  • ID prevalence was 36% (22/61), notably higher (52%) in women, often with normal hemoglobin.
  • Patients with ID exhibited lower peak oxygen uptake (V̇O2peak) (p=0.039), though confounded by sex.
  • ID increased the likelihood of not achieving a respiratory exchange ratio (RER) ≥1.1 by 5-fold (p=0.035).

Conclusions:

  • Iron deficiency is highly prevalent in Fontan circulation patients.
  • Reduced V̇O2peak is observed in Fontan patients with ID.
  • Fontan patients with ID are less likely to achieve an RER≥1.1 during exercise testing.
Abstract

Keywords:
Congenital AbnormalitiesFontan ProcedureHeart Defects, Congenital

More Related Videos

Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure04:20

Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure

Published on: October 1, 2019

5.8K
Skeletal Muscle Neurovascular Coupling, Oxidative Capacity, and Microvascular Function with 'One Stop Shop' Near-infrared Spectroscopy09:04

Skeletal Muscle Neurovascular Coupling, Oxidative Capacity, and Microvascular Function with 'One Stop Shop' Near-infrared Spectroscopy

Published on: February 20, 2018

12.5K

Related Concept Videos

Exercise and Cardiac Output01:17

Exercise and Cardiac Output

Regular physical activity is essential for maintaining cardiovascular health, with aerobic exercises being particularly effective. According to the American Heart Association, 150 minutes of moderate to intense aerobic exercise per week is recommended for a healthy heart. Aerobic activities may include brisk walking, running, bicycling, cross-country skiing, and swimming, ideally performed three to five times per week.
Sustained exercise increases the muscles' oxygen demand, which can be...
985
Exercise and Cardiovascular Response01:20

Exercise and Cardiovascular Response

Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
784
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
Factors Affecting Erythropoiesis01:24

Factors Affecting Erythropoiesis

The cardiovascular system regulates the number of erythrocytes in the bloodstream to ensure optimal oxygen transport. It also prevents over-proliferation of these cells, which helps to maintain blood viscosity and flow rate.
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...
3.2K
Pathophysiology of Cardiac Performance01:29

Pathophysiology of Cardiac Performance

Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
635
Cardiac Output II: Effect of Stroke Volume on Cardiac Output01:22

Cardiac Output II: Effect of Stroke Volume on Cardiac Output

Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
847