{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:34:26Z","timestamp":1792971266209,"version":"4.5.0"},"reference-count":37,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:00:00Z","timestamp":1792886400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart Lung and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jpeds.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pediatrics"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jpeds.2026.115379","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T15:37:31Z","timestamp":1792769851000},"page":"115379","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise Capacity, Muscle Mass, and Quality of Life in Pediatric Patients with Fontan Circulation"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5047-0893","authenticated-orcid":false,"given":"Jerin T.","family":"Jose","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bernstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latha","family":"Palaniappan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary B.","family":"Leonard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mavis","family":"Lui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0777-7911","authenticated-orcid":false,"given":"Joseph","family":"Dehoney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Olson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Schnieder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seda","family":"Tierney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.jpeds.2026.115379_bib1","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.jtcvs.2017.01.056","article-title":"Long-term survival after the Fontan operation: Twenty years of experience at a single center","volume":"154","author":"Downing","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"24","key":"10.1016\/j.jpeds.2026.115379_bib2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/JAHA.120.016850","article-title":"End-organ function and exercise performance in patients with fontan circulation: What characterizes the high performers?","volume":"9","author":"Weinreb","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"4","key":"10.1016\/j.jpeds.2026.115379_bib3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.acvd.2017.09.001","article-title":"Cardiopulmonary exercise testing in the evaluation of liver disease in adults who have had the Fontan operation","volume":"111","author":"Agarwal","year":"2018","journal-title":"Arch Cardiovasc Dis"},{"issue":"3","key":"10.1016\/j.jpeds.2026.115379_bib4","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1017\/S104795111500181X","article-title":"Quality of life in adolescents and young adults with CHD is not reduced: A systematic review and meta-analysis","volume":"26","author":"Schr\u00f8der","year":"2016","journal-title":"Cardiol Young"},{"issue":"1","key":"10.1016\/j.jpeds.2026.115379_bib5","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s00246-020-02465-1","article-title":"Exercise Capacity and Predictors of Performance After Fontan: Results from the Pediatric Heart Network Fontan 3 Study","volume":"42","author":"Goldberg","year":"2021","journal-title":"Pediatr Cardiol"},{"key":"10.1016\/j.jpeds.2026.115379_bib6","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.ahj.2017.04.009","article-title":"Decline in peak oxygen consumption over time predicts death or transplantation in adults with a Fontan circulation","volume":"189","author":"Cunningham","year":"2017","journal-title":"Am Heart J"},{"issue":"3","key":"10.1016\/j.jpeds.2026.115379_bib7","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.amjcard.2011.03.064","article-title":"Usefulness of peripheral vascular function to predict functional health status in patients with fontan circulation","volume":"108","author":"Goldstein","year":"2011","journal-title":"Am J Cardiol"},{"issue":"6","key":"10.1016\/j.jpeds.2026.115379_bib8","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1161\/CIRCULATIONAHA.104.529800","article-title":"Exercise intolerance in adult congenital heart disease: Comparative severity, correlates, and prognostic implication","volume":"112","author":"Diller","year":"2005","journal-title":"Circulation"},{"issue":"6","key":"10.1016\/j.jpeds.2026.115379_bib9","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1017\/S1047951115000086","article-title":"Determinants of quality of life in children and adolescents with CHD: A systematic review","volume":"25","author":"Drakouli","year":"2015","journal-title":"Cardiol Young"},{"issue":"6","key":"10.1016\/j.jpeds.2026.115379_bib10","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.014172","article-title":"Health-related quality of life in children, adolescents, and adults with a fontan circulation: A meta-analysis","volume":"9","author":"Marshall","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jpeds.2026.115379_bib11","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpeds.2024.114156","article-title":"Wellbeing in Children and Adolescents with Fontan Physiology","volume":"273","author":"Marshall","year":"2024","journal-title":"J Pediatr"},{"issue":"6","key":"10.1016\/j.jpeds.2026.115379_bib12","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1136\/adc.2006.105239","article-title":"Physical activity levels in children and adolescents are reduced after the Fontan procedure, independent of exercise capacity, and are associated with lower perceived general health","volume":"92","author":"McCrindle","year":"2007","journal-title":"Arch Dis Child"},{"issue":"1","key":"10.1016\/j.jpeds.2026.115379_bib13","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/apa.16121","article-title":"Endurance training may improve exercise capacity, lung function and quality of life in Fontan patients","volume":"111","author":"Hedlund","year":"2022","journal-title":"Acta Paediatr Int J Paediatr"},{"issue":"8","key":"10.1016\/j.jpeds.2026.115379_bib14","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1097\/00005650-200108000-00006","article-title":"PedsQLTM 4.0: Reliability and Validity of the Pediatric Quality of Life InventoryTM Version 4.0 Generic Core Scales in Healthy and Patient Populations","volume":"39","author":"Varni","year":"2001","journal-title":"Med Care"},{"issue":"8","key":"10.1016\/j.jpeds.2026.115379_bib15","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1161\/CIRCULATIONAHA.105.576660","article-title":"Relationship of patient and medical characteristics to health status in children and adolescents after the Fontan procedure","volume":"113","author":"McCrindle","year":"2006","journal-title":"Circulation"},{"issue":"9","key":"10.1016\/j.jpeds.2026.115379_bib16","first-page":"S294","article-title":"Functional health status of adolescents after the Fontan procedure - Comparison with their siblings","volume":"25","author":"Manlhiot","year":"2009","journal-title":"Can J Cardiol"},{"issue":"2","key":"10.1016\/j.jpeds.2026.115379_bib17","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jacc.2008.01.074","article-title":"Contemporary Outcomes After the Fontan Procedure. A Pediatric Heart Network Multicenter Study","volume":"52","author":"Anderson","year":"2008","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"10.1016\/j.jpeds.2026.115379_bib18","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.ahj.2013.04.013","article-title":"Age at Fontan procedure impacts exercise performance in adolescents: Results from the Pediatric Heart Network Multicenter study","volume":"166","author":"Madan","year":"2013","journal-title":"Am Heart J"},{"issue":"21","key":"10.1016\/j.jpeds.2026.115379_bib19","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1136\/heartjnl-2014-305723","article-title":"Lean mass deficits, vitamin D status and exercise capacity in children and young adults after Fontan palliation","volume":"100","author":"Avitabile","year":"2014","journal-title":"Heart"},{"issue":"1","key":"10.1016\/j.jpeds.2026.115379_bib20","doi-asserted-by":"crossref","first-page":"72","DOI":"10.5603\/CJ.a2017.0078","article-title":"What determines the quality of life of adult patients after fontan procedure?","volume":"25","author":"Sma\u015b-Suska","year":"2018","journal-title":"Cardiol J"},{"issue":"January","key":"10.1016\/j.jpeds.2026.115379_bib21","first-page":"1","article-title":"Exercise Intolerance, Benefits, and Prescription for People Living With a Fontan Circulation: The Fontan Fitness Intervention Trial (F-FIT)\u2014Rationale and Design","volume":"9","author":"Tran","year":"2022","journal-title":"Front Pediatr"},{"key":"10.1016\/j.jpeds.2026.115379_bib22","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ahj.2023.02.006","article-title":"Design and rationale of re-energize fontan: Randomized exercise intervention designed to maximize fitness in fontan patients","volume":"259","author":"Selamet Tierney","year":"2023","journal-title":"Am Heart J"},{"issue":"24","key":"10.1016\/j.jpeds.2026.115379_bib23","doi-asserted-by":"crossref","first-page":"3073","DOI":"10.1093\/eurheartj\/ehq356","article-title":"Predictors of morbidity and mortality in contemporary Fontan patients: Results from a multicenter study including cardiopulmonary exercise testing in 321 patients","volume":"31","author":"Diller","year":"2010","journal-title":"Eur Heart J"},{"issue":"2","key":"10.1016\/j.jpeds.2026.115379_bib24","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1161\/CIRCULATIONAHA.111.058719","article-title":"Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term","volume":"125","author":"Inuzuka","year":"2012","journal-title":"Circulation"},{"issue":"June","key":"10.1016\/j.jpeds.2026.115379_bib25","first-page":"1","article-title":"Physical Activity in Fontan Patients Relates to Quality of Life and Sleep Quality","volume":"9","author":"Callegari","year":"2022","journal-title":"Front Cardiovasc Med"},{"issue":"3","key":"10.1016\/j.jpeds.2026.115379_bib26","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.jtcvs.2017.10.047","article-title":"Super-Fontan: Is it possible?","volume":"155","author":"Cordina","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"20","key":"10.1016\/j.jpeds.2026.115379_bib27","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1136\/heartjnl-2013-304249","article-title":"Skeletal muscle abnormalities and exercise capacity in adults with a Fontan circulation","volume":"99","author":"Cordina","year":"2013","journal-title":"Heart"},{"issue":"24","key":"10.1016\/j.jpeds.2026.115379_bib28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/JAHA.120.018345","article-title":"Body composition and exercise performance in youth with a fontan circulation: A bio-impedance based study","volume":"9","author":"Powell","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"2","key":"10.1016\/j.jpeds.2026.115379_bib29","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/00005650-199902000-00003","article-title":"The PedsQL Measurement Model for the Pediatric","volume":"37","author":"Varni","year":"1999","journal-title":"Med Care"},{"issue":"April","key":"10.1016\/j.jpeds.2026.115379_bib30","article-title":"Deriving fontan-specific normative exercise data from well-functioning adolescents","volume":"17","author":"Laohachai","year":"2024","journal-title":"Int J Cardiol Congenit Hear Dis"},{"key":"10.1016\/j.jpeds.2026.115379_bib31","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.jpeds.2015.11.016","article-title":"Assessment of Quality of Life in Young Patients with Single Ventricle after the Fontan Operation","volume":"170","author":"Uzark","year":"2016","journal-title":"J Pediatr"},{"issue":"22","key":"10.1016\/j.jpeds.2026.115379_bib32","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1016\/j.jacc.2017.03.582","article-title":"Longitudinal Outcomes of Patients With Single Ventricle After the Fontan Procedure","volume":"69","author":"Atz","year":"2017","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"10.1016\/j.jpeds.2026.115379_bib33","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1161\/CIRCULATIONAHA.109.869396","article-title":"Laboratory measures of exercise capacity and ventricular characteristics and function are weakly associated with functional health status after fontan procedure","volume":"121","author":"McCrindle","year":"2010","journal-title":"Circulation"},{"issue":"4","key":"10.1016\/j.jpeds.2026.115379_bib34","doi-asserted-by":"crossref","first-page":"3230","DOI":"10.1016\/j.ijcard.2013.04.008","article-title":"Quality of life and cognitive function in Fontan patients, a population-based study","volume":"168","author":"Idorn","year":"2013","journal-title":"Int J Cardiol"},{"issue":"24","key":"10.1016\/j.jpeds.2026.115379_bib35","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.026181","article-title":"Scaling Peak Oxygen Consumption for Body Size and Composition in People With a Fontan Circulation","volume":"11","author":"Wadey","year":"2022","journal-title":"J Am Heart Assoc"},{"issue":"8","key":"10.1016\/j.jpeds.2026.115379_bib36","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1136\/heartjnl-2017-311661","article-title":"Leg lean mass correlates with exercise systemic output in young Fontan patients","volume":"104","author":"Avitabile","year":"2018","journal-title":"Heart"},{"issue":"5","key":"10.1016\/j.jpeds.2026.115379_bib37","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2006-3778","article-title":"Quality of life in children with heart disease as perceived by children and parents","volume":"121","author":"Uzark","year":"2008","journal-title":"Pediatrics"}],"container-title":["The Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022347626004075?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0022347626004075?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T22:50:29Z","timestamp":1792968629000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0022347626004075"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":37,"alternative-id":["S0022347626004075"],"URL":"https:\/\/doi.org\/10.1016\/j.jpeds.2026.115379","relation":{},"ISSN":["0022-3476"],"issn-type":[{"value":"0022-3476","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Exercise Capacity, Muscle Mass, and Quality of Life in Pediatric Patients with Fontan Circulation","name":"articletitle","label":"Article Title"},{"value":"The Journal of Pediatrics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jpeds.2026.115379","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"115379"}}