{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:15:51Z","timestamp":1784790951354,"version":"3.55.0"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951125001337_as1\"><jats:title>Background:<\/jats:title><jats:p>Malnutrition is a relevant prognostic factor in cardiovascular disease. However, it has not been studied in adults with CHD and Fontan circulation.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951125001337_as2\"><jats:title>Methods:<\/jats:title><jats:p>Retrospective, single-centre cohort study including all consecutive adults with Fontan circulation. Objectives: 1. To evaluate the prevalence of malnutrition, defined according to Controlling Nutritional Status score, which includes albumin, lymphocytes, and cholesterol and 2. To assess its utility as a prognostic marker.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951125001337_as3\"><jats:title>Results:<\/jats:title><jats:p>We included 93 patients (55.9% male) with a mean age of 32.7 \u00b1 8.3 years. After a median follow-up of 5.5 years (interquartile range 2.2 \u2013 10.6), 14 patients met the combined primary outcome of death or heart transplant (15.1%). Moderate or severe malnutrition (Controlling Nutritional Status score \u2265 5) was detected in 18.3%. Overweight was found in 21.5% of patients, obesity in 4.3%, and low weight in 8.6%, with no significant differences in malnutrition parameters across weight categories. Patients with malnutrition had worse functional capacity (58.8% in New York Heart Association\u2014NYHA-class III\u2013IV, vs. 33.3% in patients without malnutrition, <jats:italic>p<\/jats:italic> = 0.05).<\/jats:p><jats:p>In univariate analysis, malnutrition was associated with a worse prognosis (death or heart transplant) with a hazard ratio of 3.7 (95% confidence interval 1.3 to 10.7, <jats:italic>p<\/jats:italic> = 0.01). In the adjusted model including cyanosis, functional class, and protein-losing enteropathy, malnutrition did not reach statistical significance (<jats:italic>p<\/jats:italic> = 0.81).<\/jats:p><\/jats:sec><jats:sec id=\"S1047951125001337_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Malnutrition as defined by Controlling Nutritional Status score is common in adults with Fontan circulation and represents a strong prognostic marker. Controlling Nutritional Status scale could be used in Fontan patients as a simple tool to identify a high-risk population.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951125001337","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T08:37:56Z","timestamp":1742200676000},"page":"836-841","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and prognostic value of malnutrition in adults with Fontan circulation: retrospective cohort study"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7187-8732","authenticated-orcid":false,"given":"Pablo","family":"Meras","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Cobarro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Merino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Ruiz-Cantador","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Balbacid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"Abelleira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul","family":"Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"S1047951125001337_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.08.002"},{"key":"S1047951125001337_ref19","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18189931"},{"key":"S1047951125001337_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12296"},{"key":"S1047951125001337_ref6","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114536735"},{"key":"S1047951125001337_ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-020-09937-9"},{"key":"S1047951125001337_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/00369330221122300"},{"key":"S1047951125001337_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.02.018"},{"key":"S1047951125001337_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951120001419"},{"key":"S1047951125001337_ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-021-02628-8"},{"key":"S1047951125001337_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02465-1"},{"key":"S1047951125001337_ref16","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951123004389"},{"key":"S1047951125001337_ref9","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.2437"},{"key":"S1047951125001337_ref20","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12754"},{"key":"S1047951125001337_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.03.232"},{"key":"S1047951125001337_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.02.025"},{"key":"S1047951125001337_ref15","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13294"},{"key":"S1047951125001337_ref10","first-page":"825","article-title":"Nutrition status, obesity and outcomes in patients with atrial fibrillation","volume":"75","author":"Raposeiras-Roub\u00edn","year":"2022","journal-title":"Rev Espa\u00f1ola Cardiol (English Ed"},{"key":"S1047951125001337_ref8","doi-asserted-by":"publisher","DOI":"10.3390\/nu14194055"},{"key":"S1047951125001337_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2012.08.006"},{"key":"S1047951125001337_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951120000694"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951125001337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T04:02:13Z","timestamp":1743566533000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951125001337\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["S1047951125001337"],"URL":"https:\/\/doi.org\/10.1017\/s1047951125001337","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. 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