{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:09:05Z","timestamp":1785431345999,"version":"3.56.0"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2026,5]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n The Fontan procedure, a palliative surgical approach for single-ventricle physiology, has significantly improved long-term survival. However, it is frequently associated with reduced exercise capacity and multiorgan dysfunction. In this context, peripheral muscle function and body composition may influence functional outcomes.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n The aim of the study was to evaluate the relationships among body composition, handgrip strength, and functional capacity in Fontan patients, as well as to investigate the impact of Fontan-related variables on these parameters.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This single-centre study included 30 clinically stable patients (age range: 7.0\u201333.0 years) with Fontan circulation. Data collected included pre-operative primary diagnosis, pre-Fontan mean pulmonary artery pressure, and laboratory parameters such as B-type natriuretic peptide, haemoglobin, creatinine, alanine aminotransferase, aspartate aminotransferase, albumin, and uric acid levels. 6-minute walk test (6MWT), handgrip strength, and body composition via bioelectrical impedance were assessed. Correlation and subgroup analyses were performed according to pre-Fontan surgery history, Bidirectional Glenn, Fontan type, fenestration, and other clinical factors.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The median 6MWT distance was 564 m, handgrip strength was 28.3 \u00b1 11.1 kg, and \u0394SpO\n 2<\/jats:sub>\n was 4% (IQR: 2\u20135). Patients with intra-extracardiac Fontan and fenestration exhibited significantly higher \u0394SpO\n 2<\/jats:sub>\n (\n p<\/jats:italic>\n = 0.03 and\n p<\/jats:italic>\n = 0.003, respectively). \u0394SpO\n 2<\/jats:sub>\n was inversely correlated with 6MWT distance (\n r<\/jats:italic>\n = \u22120.531,\n p<\/jats:italic>\n = 0.008) and handgrip strength (\n r<\/jats:italic>\n = \u22120.472,\n p<\/jats:italic>\n = 0.017). Fat-free mass was positively correlated with both 6MWT distance (\n r<\/jats:italic>\n = 0.598,\n p<\/jats:italic>\n < 0.001) and handgrip strength (\n r<\/jats:italic>\n = 0.537,\n p<\/jats:italic>\n = 0.002). Red cell distribution width was negatively correlated with 6MWT (\n r<\/jats:italic>\n = \u22120.631,\n p<\/jats:italic>\n < 0.001) and grip strength (\n r<\/jats:italic>\n = \u22120.413,\n p<\/jats:italic>\n = 0.029).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n In Fontan patients, reduced handgrip strength, lower fat-free mass, and greater post-exercise oxygen desaturation were associated with impaired exercise capacity, supporting the clinical value of simple functional and muscle strength assessments in routine follow-up.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/s1047951126113079","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:16:36Z","timestamp":1779171396000},"page":"936-942","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Extracardiac predictors of functional capacity in a group of Fontan patients"],"prefix":"10.1017","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5379-907X","authenticated-orcid":false,"given":"Ali Cem","family":"Kucukdagli","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04kwvgz42","id-type":"ROR","asserted-by":"publisher"}],"name":"Hacettepe University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4514-4801","authenticated-orcid":false,"given":"Haluk","family":"Tekerlek","sequence":"additional","affiliation":[{"name":"University of Roehampton"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melda","family":"Saglam","sequence":"additional","affiliation":[{"name":"Hacettepe University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6607-0568","authenticated-orcid":false,"given":"Ilker","family":"Ertugrul","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1371-8399","authenticated-orcid":false,"given":"Ebru","family":"Aypar","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dursun","family":"Alehan","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tevfik","family":"Karagoz","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayrettin Hakan","family":"Aykan","sequence":"additional","affiliation":[{"name":"Hacettepe University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"S1047951126113079_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12222"},{"key":"S1047951126113079_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304249"},{"key":"S1047951126113079_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.067"},{"key":"S1047951126113079_ref16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022816"},{"key":"S1047951126113079_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2015.03.018"},{"key":"S1047951126113079_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307467"},{"key":"S1047951126113079_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2005.05.003"},{"key":"S1047951126113079_ref21","doi-asserted-by":"publisher","DOI":"10.24953\/turkjpediatr.2024.4570"},{"key":"S1047951126113079_ref8","first-page":"36","article-title":"The validity of a bioelectrical impedance analyzer, Xiaomi MI scale 2, for measurement of body composition","volume":"2","author":"Alidadi","year":"2019","journal-title":"Food 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2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}