{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:59:56Z","timestamp":1773251996441,"version":"3.50.1"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T00:00:00Z","timestamp":1574380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"DOI":"10.3389\/fphys.2019.01443","type":"journal-article","created":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T05:58:45Z","timestamp":1574402325000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Altered Hemorheology in Fontan Patients in Normoxia and After Acute Hypoxic Exercise"],"prefix":"10.3389","volume":"10","author":[{"given":"Julian Alexander","family":"H\u00e4rtel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Herberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Breuer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Alexander","family":"Bizjak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilhelm","family":"Bloch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marijke","family":"Grau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2019,11,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-014-0523-z","article-title":"The conundrum of arterial stiffness, elevated blood pressure, and aging.","volume":"17","author":"AlGhatrif","year":"2015","journal-title":"Curr. Hypertens Rep."},{"key":"B2","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1097\/HJH.0b013e3282f314f7","article-title":"A new oscillometric method for assessment of arterial stiffness: comparison with tonometric and piezo-electronic methods.","volume":"26","author":"Baulmann","year":"2008","journal-title":"J. Hypertens."},{"key":"B3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1017\/S1047951105000065","article-title":"Evidence of endothelial dysfunction in patients with functionally univentricular physiology before completion of the Fontan operation.","volume":"15","author":"Binotto","year":"2005","journal-title":"Cardiol. Young"},{"key":"B4","doi-asserted-by":"publisher","first-page":"H1577","DOI":"10.1152\/ajpheart.00665.2002","article-title":"Effects of nitric oxide on red blood cell deformability.","volume":"284","author":"Bor-Kucukatay","year":"2003","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B5","first-page":"89","article-title":"The triphasic effects of exercise on blood rheology: which relevance to physiology and pathophysiology?","volume":"19","author":"Brun","year":"1998","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"B6","first-page":"201","article-title":"Maximal oxygen uptake and lactate thresholds during exercise are related to blood viscosity and erythrocyte aggregation in professional football players.","volume":"5","author":"Brun","year":"1995","journal-title":"Clin. Hemorheol."},{"key":"B7","first-page":"105","article-title":"Low values of blood viscosity and erythrocyte aggregation are associated with lower increases in blood lactate during submaximal exercise.","volume":"14","author":"Brun","year":"1994","journal-title":"Clin. Hemorheol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1007\/s00246-016-1352-4","article-title":"Elevated low-shear blood viscosity is associated with decreased pulmonary blood flow in children with univentricular heart defects.","volume":"37","author":"Cheng","year":"2016","journal-title":"Pediatr. Cardiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1249\/MSS.0000000000000730","article-title":"Cycling exercise training alleviates hypoxia-impaired erythrocyte rheology.","volume":"48","author":"Chou","year":"2016","journal-title":"Med. Sci. Sports Exerc."},{"key":"B10","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.mvr.2014.01.009","article-title":"Nitric oxide and hypoxia stimulate erythropoietin receptor via MAPK kinase in endothelial cells.","volume":"92","author":"Cokic","year":"2014","journal-title":"Microvasc. Res."},{"key":"B11","doi-asserted-by":"publisher","first-page":"187","DOI":"10.3233\/CH-2012-1643","article-title":"Exercise hemorheology: classical data, recent findings and unresolved issues.","volume":"53","author":"Connes","year":"2013","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"B12","doi-asserted-by":"publisher","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"},{"key":"B13","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1177\/000331977702801108","article-title":"Blood viscosity factors in evaluation of submaximal work output and cardiac activity in men.","volume":"28","author":"Dintenfass","year":"1977","journal-title":"Angiology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1161\/01.cir.81.6.2016","article-title":"Cardiorespiratory responses to exercise after the Fontan operation.","volume":"81","author":"Driscoll","year":"1990","journal-title":"Circulation"},{"key":"B15","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.ahj.2015.06.018","article-title":"Does exercise training improve cardiopulmonary fitness and daily physical activity in children and young adults with corrected tetralogy of fallot or fontan circulation? a randomized controlled trial.","volume":"170","author":"Duppen","year":"2015","journal-title":"Am. Heart J."},{"key":"B16","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1136\/thx.26.3.240","article-title":"Surgical repair of tricuspid atresia.","volume":"26","author":"Fontan","year":"1971","journal-title":"Thorax"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1182\/blood-2008-01-115261","article-title":"The functional nitrite reductase activity of the heme-globins.","volume":"112","author":"Gladwin","year":"2008","journal-title":"Blood"},{"key":"B18","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.jchromb.2007.02.002","article-title":"Recent methodological advances in the analysis of nitrite in the human circulation: nitrite as a biochemical parameter of the L-arginine\/NO pathway.","volume":"851","author":"Grau","year":"2007","journal-title":"J. Chromatogr. B Anal. Technol. Biomed. Life Sci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3233\/CH-162044","article-title":"Regulation of red blood cell deformability is independent of red blood cell-nitric oxide synthase under hypoxia.","volume":"63","author":"Grau","year":"2016","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"B20","first-page":"1","article-title":"The Laser-assisted optical rotational cell analyzer (LORCA) as red blood cell aggregometer.","volume":"25","author":"Hardeman","year":"2001","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"B21","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/S0076-6879(08)01216-0","article-title":"Reductive gas-phase chemiluminescence and flow injection analysis for measurement of the nitric oxide pool in biological matrices.","volume":"441","author":"Hendgen-Cotta","year":"2008","journal-title":"Methods Enzymol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1097\/HJH.0b013e32833c8a1a","article-title":"Invasive validation of a new oscillometric device (Arteriograph) for measuring augmentation index, central blood pressure and aortic pulse wave velocity.","volume":"28","author":"Horvath","year":"2010","journal-title":"J. Hypertens."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019240","article-title":"Efficacy of iron supplementation on fatigue and physical capacity in non-anaemic iron-deficient adults: a systematic review of randomised controlled trials.","volume":"8","author":"Houston","year":"2018","journal-title":"BMJ Open"},{"key":"B24","doi-asserted-by":"publisher","first-page":"91","DOI":"10.3233\/bir-1994-31108","article-title":"Cellular deformability of normoxic and hypoxic mammalian red blood cells.","volume":"31","author":"Kaniewski","year":"1994","journal-title":"Biorheology"},{"key":"B25","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1111\/j.1651-2227.2007.00101.x","article-title":"Effects of erythropoietin on erythrocyte deformability in non-transfused preterm infants.","volume":"96","author":"Klipp","year":"2007","journal-title":"Acta Paediatr."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1001\/jama.2009.681","article-title":"Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis.","volume":"301","author":"Kodama","year":"2009","journal-title":"JAMA"},{"key":"B27","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1089\/rej.2014.1573","article-title":"Markers of oxidative stress in senescent erythrocytes obtained from young and old age rats.","volume":"17","author":"Kumar","year":"2014","journal-title":"Rejuvenat. Res."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1016\/j.ijcard.2012.04.015","article-title":"Sympathetic and vascular dysfunction in adult patients with Fontan circulation.","volume":"167","author":"Lambert","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1080\/14017430310007045","article-title":"Decreased lung function and exercise capacity in Fontan patients. a long-term follow-up.","volume":"37","author":"Larsson","year":"2003","journal-title":"Scand. Cardiovasc. J."},{"key":"B30","first-page":"515","article-title":"Endothelial vasoactive factors: predictive markers of the results of the Fontan intervention?","volume":"97","author":"Levy","year":"2004","journal-title":"Arch. Mal. Coeur. Vaiss"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2013.00387","article-title":"Mechanisms tagging senescent red blood cells for clearance in healthy humans.","volume":"4","author":"Lutz","year":"2013","journal-title":"Front. Physiol."},{"key":"B32","first-page":"390","article-title":"H\u00f6henakklimatisation.","volume":"12","author":"Mairb\u00e4url","year":"2000","journal-title":"Deutsche Zeitschrift Sportmedizin"},{"key":"B33","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1152\/japplphysiol.00096.2011","article-title":"Hypoxic exercise training causes erythrocyte senescence and rheological dysfunction by depressed Gardos channel activity.","volume":"111","author":"Mao","year":"2011","journal-title":"J. Appl. Physiol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1111\/j.1747-0803.2012.00708.x","article-title":"Iron deficiency anemia detection from hematology parameters in adult congenital heart disease patients.","volume":"8","author":"Martinez-Quintana","year":"2013","journal-title":"Congenit Heart Dis."},{"key":"B35","doi-asserted-by":"publisher","first-page":"451","DOI":"10.3233\/CH-16163","article-title":"Effects of various acute hypoxic conditions on the hemorheological response during exercise and recovery1.","volume":"63","author":"Moon","year":"2016","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1136\/heartjnl-2017-312753","article-title":"Hypoxic Challenge Testing (Fitness to Fly) in children with complex congenital heart disease.","volume":"104","author":"Naqvi","year":"2018","journal-title":"Heart"},{"key":"B37","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1111\/j.1749-6632.1983.tb35218.x","article-title":"Hemorheology in cerebrovascular diseases: approaches to drug development.","volume":"416","author":"Nordt","year":"1983","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.1016\/s0735-1097(01)01266-9","article-title":"Influence of ventricular morphology on aerobic exercise capacity in patients after the Fontan operation.","volume":"37","author":"Ohuchi","year":"2001","journal-title":"J. Am. College Cardiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"H2145","DOI":"10.1152\/ajpheart.1999.277.6.H2145","article-title":"Capillary recruitment in response to tissue hypoxia and its dependence on red blood cell deformability.","volume":"277","author":"Parthasarathi","year":"1999","journal-title":"Am. J. Physiol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1007\/978-1-4614-4989-8-29","article-title":"Association of the red cell distribution width with red blood cell deformability.","volume":"765","author":"Patel","year":"2013","journal-title":"Adv. Exp. Med. Biol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1016\/j.freeradbiomed.2006.05.001","article-title":"The measurement of blood and plasma nitrite by chemiluminescence: pitfalls and solutions.","volume":"41","author":"Pelletier","year":"2006","journal-title":"Free Radic. Biol. Med."},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.00375","article-title":"The effects of altitude training on erythropoietic response and hematological variables in adult athletes: a narrative review.","volume":"9","author":"Ploszczyca","year":"2018","journal-title":"Front. Physiol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1016\/j.freeradbiomed.2010.12.009","article-title":"Exercise-induced oxidative stress in humans: cause and consequences.","volume":"51","author":"Powers","year":"2011","journal-title":"Free Radic. Biol. Med."},{"key":"B44","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.healun.2015.01.005","article-title":"Adverse pulmonary vascular remodeling in the Fontan circulation.","volume":"34","author":"Ridderbos","year":"2015","journal-title":"J. Heart Lung Transpl."},{"key":"B45","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1097\/PCC.0000000000001017","article-title":"RBC distribution width: biomarker for red cell dysfunction and critical illness outcome?","volume":"18","author":"Said","year":"2017","journal-title":"Pediatr. Crit. Care Med."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1007\/bf01936936","article-title":"Role of erythropoietin in adaptation to hypoxia.","volume":"46","author":"Scholz","year":"1990","journal-title":"Experientia"},{"key":"B47","doi-asserted-by":"publisher","first-page":"291","DOI":"10.3969\/j.issn.1671-5411.2013.03.010","article-title":"Blood rheology and aging.","volume":"10","author":"Simmonds","year":"2013","journal-title":"J. Geriatr. Cardiol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"H2188","DOI":"10.1152\/ajpheart.1999.276.6.H2188","article-title":"Greater erythrocyte deformability in world-class endurance athletes.","volume":"276","author":"Smith","year":"1999","journal-title":"Am. J. Physiol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1136\/heartjnl-2016-309682","article-title":"Cardiopulmonary adaptation to short-term high altitude exposure in adult Fontan patients.","volume":"102","author":"Staempfli","year":"2016","journal-title":"Heart"},{"key":"B50","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1016\/j.athoracsur.2004.03.039","article-title":"Increased vascular endothelial growth factor in patients with cyanotic congenital heart diseases may not be normalized after a Fontan type operation.","volume":"78","author":"Suda","year":"2004","journal-title":"Ann. Thorac. Surg."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045982","article-title":"Moderate exercise promotes human RBC-NOS activity, NO production and deformability through Akt kinase pathway.","volume":"7","author":"Suhr","year":"2012","journal-title":"PLoS One"},{"key":"B52","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.niox.2008.10.004","article-title":"Intensive exercise induces changes of endothelial nitric oxide synthase pattern in human erythrocytes.","volume":"20","author":"Suhr","year":"2009","journal-title":"Nitric. Oxide"},{"key":"B53","doi-asserted-by":"publisher","first-page":"775","DOI":"10.2459\/JCM.0b013e328011c999","article-title":"Exercise limitation in patients with Fontan circulation: a review.","volume":"8","author":"Takken","year":"2007","journal-title":"J. Cardiovasc. Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"357","DOI":"10.5114\/kitp.2013.39737","article-title":"Cardiac surgery Long-term follow-up in adult patients after Fontan operations.","volume":"4","author":"Tomkiewicz-Paj\u0105k","year":"2013","journal-title":"Pol. J. Cardio Thoracic Surg."},{"key":"B55","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.jjcc.2014.02.021","article-title":"Iron deficiency and hematological changes in adult patients after Fontan operation.","volume":"64","author":"Tomkiewicz-Pajak","year":"2014","journal-title":"J. Cardiol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"503","DOI":"10.3233\/CH-189202","article-title":"Deformability of different red blood cell populations and viscosity of differently trained young men in response to intensive and moderate running.","volume":"69","author":"Tomschi","year":"2018","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"B57","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.3324\/haematol.2008.005371","article-title":"Red blood cell aggregation, aggregate strength and oxygen transport potential of blood are abnormal in both homozygous sickle cell anemia and sickle-hemoglobin C disease.","volume":"94","author":"Tripette","year":"2009","journal-title":"Haematologica"},{"key":"B58","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1007\/s00246-017-1606-9","article-title":"Impaired pulmonary function is an additional potential mechanism for the reduction of functional capacity in clinically stable fontan patients.","volume":"38","author":"Turquetto","year":"2017","journal-title":"Pediatr. Cardiol."},{"key":"B59","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.ijcard.2018.05.096","article-title":"Blunted peripheral blood supply and underdeveloped skeletal muscle in Fontan patients: The impact on functional capacity.","volume":"271","author":"Turquetto","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/S0006-3495(92)81625-9","article-title":"Oxygenation-deoxygenation cycle of erythrocytes modulates submicron cell membrane fluctuations.","volume":"63","author":"Tuvia","year":"1992","journal-title":"Biophys. J."},{"key":"B61","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.niox.2011.03.003","article-title":"Shear stress activation of nitric oxide synthase and increased nitric oxide levels in human red blood cells.","volume":"24","author":"Ulker","year":"2011","journal-title":"Nitric Oxide"},{"key":"B62","first-page":"139","article-title":"Reduction of red blood cell disaggregability during submaximal exercise: relationship with fibrinogen levels.","volume":"28","author":"Varlet-Marie","year":"2003","journal-title":"Clin. Hemorheol. Microcirc."},{"key":"B63","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1159\/000178201","article-title":"Red blood cell aggregation and microcirculation in rat cremaster muscle.","volume":"14","author":"Vicaut","year":"1994","journal-title":"Int. J. Microcirc. Clin. Exp."},{"key":"B64","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/j.neuron.2016.07.016","article-title":"Erythrocytes are oxygen-sensing regulators of the cerebral microcirculation.","volume":"91","author":"Wei","year":"2016","journal-title":"Neuron"},{"key":"B65","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1152\/japplphysiol.00368.2002","article-title":"Time course of hemorheological alterations after heavy anaerobic exercise in untrained human subjects.","volume":"94","author":"Yalcin","year":"2003","journal-title":"J. Appl. Physiol."},{"key":"B66","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.cca.2015.05.021","article-title":"Persistent increase in red cell size distribution width after acute diseases: a biomarker of hypoxemia?","volume":"448","author":"Ycas","year":"2015","journal-title":"Clin. Chim. Acta"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/article\/10.3389\/fphys.2019.01443\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T05:58:49Z","timestamp":1574402329000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/article\/10.3389\/fphys.2019.01443\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,22]]},"references-count":66,"alternative-id":["10.3389\/fphys.2019.01443"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2019.01443","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,22]]},"article-number":"1443"}}