{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T17:47:34Z","timestamp":1770918454423,"version":"3.50.1"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,12,17]]},"abstract":"\n Background<\/jats:title>\n \n Peak oxygen consumption (peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n ) is traditionally scaled by body mass, but it is most appropriately scaled by fat\u2010free mass. However, it is unknown whether peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n scaled by fat\u2010free mass is associated with mortality and morbidity in people with a Fontan circulation. The aim of this study was to assess the associations between different expressions of peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n with mortality and morbidity in people with a Fontan circulation.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Eighty\u2010seven participants (aged 24.1\u00b17.3\u2009years; 53% women) with a Fontan circulation completed a cardiopulmonary exercise test and a dual\u2010energy x\u2010ray absorptiometry scan. Cox proportional hazard regressions models assessed the association (hazard ratio [HR]) between different expressions of peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n with a composite outcome of Fontan failure (FF). Participants were followed up for a median of 6.5\u2009years (95% CI, 6.4\u20136.9). Individuals experiencing FF (n=10\/87) had a significantly lower absolute peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n . In univariable models, peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n ratio scaled to body mass was not significantly associated with FF (HR, 0.91;\n P<\/jats:italic>\n =0.111). However, peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n scaled by fat\u2010free mass (HR, 0.90;\n P<\/jats:italic>\n =0.020) or lean mass (HR, 0.90;\n P<\/jats:italic>\n =0.017) was significantly and inversely associated with FF. These associations remained significant after adjusting for age, sex, and peak respiratory exchange ratio.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The association between peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n and FF is improved when scaled to measures of body composition. Applied clinically, a 1\u2010unit increase in peak\n \n \n \n \n V<\/mml:mi>\n \u0307<\/mml:mo>\n <\/mml:mover>\n <\/mml:mrow>\n $$ \\dot{\\mathrm{V}} $$<\/mml:annotation>\n <\/mml:semantics>\n <\/mml:math>\n O\n 2<\/jats:sub>\n scaled to fat\u2010free mass or lean mass is associated with a \u224810% lower risk of FF.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.123.034944","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T09:51:01Z","timestamp":1734169861000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Peak Oxygen Consumption Scaled to Body Composition Is Associated With Mortality and Morbidity in People With a Fontan Circulation"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3275-7975","authenticated-orcid":false,"given":"Curtis A.","family":"Wadey","sequence":"first","affiliation":[{"name":"Children\u2019s Health & Exercise Research Centre (CHERC) Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter Exeter United Kingdom"},{"name":"Research and Improvement Hampshire and Isle of Wight Healthcare NHS Foundation Trust Hampshire United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8610-5417","authenticated-orcid":false,"given":"Alan R.","family":"Barker","sequence":"additional","affiliation":[{"name":"Children\u2019s Health & Exercise Research Centre (CHERC) Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter Exeter United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2789-2216","authenticated-orcid":false,"given":"A. 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