{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:54:09Z","timestamp":1787496849203,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,4,18]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">With improving survival of patients with single ventricle physiology who underwent Fontan palliation, there is also an increase in the prevalence of overweight and obesity in these patients. This tertiary care single\u2010center study aims to determine the association of body mass index (BMI) with the clinical characteristics and outcomes in adults with Fontan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Adult patients (aged \u226518\u2009years) with Fontan who were managed at a single tertiary care center between January 1, 2000, and July 1, 2019, and had BMI data available were identified via retrospective review of medical records. Univariate and multivariable (after adjusting for age, sex, functional class, and type of Fontan) linear and logistic regression, as appropriate, were utilized to evaluate associations between BMI and diagnostic testing and clinical outcomes. A total of 163 adult patients with Fontan were included (mean age, 29.9\u00b19.08\u2009years), with a mean BMI of 24.2\u00b15.21\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (37.4% of patients had BMI \u226525\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Echocardiography data were available for 95.7% of patients, exercise testing for 39.3% of patients, and catheterization for 53.7% of patients. Each SD increase in BMI was significantly associated with decreased peak oxygen consumption (\n                      <jats:italic>P<\/jats:italic>\n                      =0.010) on univariate analysis and with increased Fontan pressure (\n                      <jats:italic>P<\/jats:italic>\n                      =0.035) and pulmonary capillary wedge pressure (\n                      <jats:italic>P<\/jats:italic>\n                      =0.037) on multivariable analysis. In addition, BMI \u226525\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      was independently associated with heart failure hospitalization (adjusted odds ratio [AOR], 10.2; 95% CI, 2.79\u201337.1 [\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001]) and thromboembolic complications (AOR, 2.79; 95% CI, 1.11\u20136.97 [\n                      <jats:italic>P<\/jats:italic>\n                      =0.029]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Elevated BMI is associated with poor hemodynamics and worse clinical outcomes in adult patients with Fontan. Whether elevated BMI is the cause or consequence of poor clinical outcomes needs to be further established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.026732","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T06:34:05Z","timestamp":1680849245000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Association of Body Mass Index With Clinical Features and Outcomes in Adults With Fontan Palliation"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6984-3602","authenticated-orcid":false,"given":"Vidhushei","family":"Yogeswaran","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4746-9693","authenticated-orcid":false,"given":"Christopher","family":"Anigwe","sequence":"additional","affiliation":[{"name":"School of Medicine University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-6162","authenticated-orcid":false,"given":"Ayesha","family":"Salahuddin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3822-693X","authenticated-orcid":false,"given":"Anita J.","family":"Moon Grady","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian S.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarthi","family":"Sabanayagam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0807-0906","authenticated-orcid":false,"given":"Peter C.","family":"Kouretas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Cardiothoracic Surgery, UCSF Benioff Children\u2019s Hospital San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6354-1873","authenticated-orcid":false,"given":"Vaikom S.","family":"Mahadevan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8535-3152","authenticated-orcid":false,"given":"Anushree","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of California San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-314937"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2014.08.024"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-015-1265-7"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2015.68"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000367"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.065"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.12.054"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.09.014"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.11.014"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-319760"},{"key":"e_1_3_2_12_2","first-page":"229","article-title":"Prevention of cardiovascular diseases: role of exercise, dietary interventions, obesity and smoking cessation","volume":"10","author":"Buttar HS","year":"2005","unstructured":"Buttar HS, Li T, Ravi N. 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