Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-18T19:09:35.842Z Has data issue: false hasContentIssue false
  • English
  • Français

Observations on obesity patterns in tetralogy of Fallot patients from childhood to adulthood

Published online by Cambridge University Press:  22 September 2016

David A. Briston ,
Aarthi Sabanayagam  and
Ali N. Zaidi
David A. Briston
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital at Montefiore, Montefiore Medical Center, Bronx, New York, United States of America
Aarthi Sabanayagam
Affiliation:
Einstein Montefiore Center for Heart and Vascular Care, Montefiore Medical Center, Bronx, New York, United States of America
Ali N. Zaidi*
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital at Montefiore, Montefiore Medical Center, Bronx, New York, United States of America Einstein Montefiore Center for Heart and Vascular Care, Montefiore Medical Center, Bronx, New York, United States of America Montefiore Adult Congenital Heart Disease (MAtCH) Program, Einstein Montefiore Center for Heart and Vascular Care, Montefiore Medical Center, Bronx, New York, United States of America
*
Correspondence to: A. N. Zaidi, MD, Montefiore Adult Congenital Heart Disease (MAtCH) Program, Montefiore Einstein Center for Heart and Vascular Care, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, United States of America. Tel: +1 718 920 5882; Fax: +1 718 920 6798; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Obesity is increasingly prevalent, and abnormal body mass index is a risk factor for cardiovascular disease. There are limited data published regarding body mass index and CHD. We tested the hypothesis that body mass index and obesity prevalence are increasing in patients with tetralogy of Fallot over time by analysing time since surgery, age, height, weight, and body mass index among tetralogy of Fallot patients and demographic data from age-matched controls. NYHA class and left ventricular ejection fraction were analysed in adults. Body mass index was categorised into normal, overweight, and obese in this single-centre, retrospective chart review. Data were collected from 137 tetralogy of Fallot patients (71 men:66 women), of whom 40 had body mass index >25 kg/m2. Tetralogy of Fallot patients aged <6 years had lower body mass index (15.9 versus 17.1; p=0.042) until 16–20 years of age (27.4 versus 25.4; p=0.43). For adult tetralogy of Fallot patients, the mean body mass index was 26.5 but not statistically significantly different from the control cohort. Obese adult patients had significantly higher average NYHA class compared with those of normal weight (p=0.03), but no differences in left ventricular ejection fraction by echocardiography (p=0.55) or cardiac MRI (p=0.26) were noted. Lower body mass index was observed initially in tetralogy of Fallot patients, but by late adolescence no significant difference was observed. As adults, tetralogy of Fallot patients with higher body mass index had increased NYHA class but similar left ventricular ejection fraction.

Keywords

Tetralogy of Fallotobesitybody mass indexCHD
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 890 - 894
Check for updates
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Flegal, KM, Carroll, MD, Ogden, CL, Johnson, CL. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–1727.CrossRefGoogle ScholarPubMed
2. Sturm, R. Increases in clinically severe obesity in the United States, 1986–2000. Arch Intern Med 2003; 163: 2146–2148.CrossRefGoogle ScholarPubMed
3. Flegal, KM, Carroll, MD, Kit, BK, Ogden, CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 2012; 307: 491–497.CrossRefGoogle ScholarPubMed
4. Yaemsiri, S, Slining, MM, Agarwal, SK. Perceived weight status, overweight diagnosis, and weight control among US adults: the NHANES 2003–2008 Study. Int J Obes 2011; 35: 1063–1070.CrossRefGoogle ScholarPubMed
5. Cheek, DB, Graystone, JE, Rowe, RD. Hypoxia and malnutrition in newborn rats: effects on RNA, DNA, and protein in tissues. Am J Physiol 1969; 217: 642–645.CrossRefGoogle ScholarPubMed
6. Cohen, MS. Clinical practice: the effect of obesity in children with congenital heart disease. Eur J Pediatr 2012; 171: 1145–1150.CrossRefGoogle ScholarPubMed
7. Pinto, NM, Marino, BS, Wernovsky, G, et al. Obesity is a common comorbidity in children with congenital and acquired heart disease. Pediatrics 2007; 120: 1157–1164.CrossRefGoogle ScholarPubMed
8. Pemberton, VL, McCrindle, BW, Barkin, S, et al. Report of the National Heart, Lung, and Blood Institute’s Working Group on obesity and other cardiovascular risk factors in congenital heart disease. Circulation 2010; 121: 1153–1159.CrossRefGoogle Scholar
9. Marelli, AJ, Ionescu-Ittu, R, Mackie, AS, Guo, L, Dendukuri, N, Kaouache, M. Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010. Circulation 2014; 130: 749–756.CrossRefGoogle ScholarPubMed
10. Hoffman, JL, Kaplan, S. The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
11. Llewellyn, A, Simmonds, M, Owen, CG, Woolacott, N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev 2016; 17: 56–67.CrossRefGoogle ScholarPubMed
12. Fogel, MA, Pawlowski, T, Keller, MS, et al. The cardiovascular effects of obesity on ventricular function and mass in patients after tetralogy of Fallot repair. J Pediatr 2015; 167: 325–330.CrossRefGoogle ScholarPubMed
13. Horner, T, Liberthson, R, Jellinek, MS. Psychosocial profile of adults with complex congenital heart disease. Mayo Clin Proc 2000; 75: 31–36.CrossRefGoogle ScholarPubMed
14. Bromberg, JI, Beasley, PJ, D’Angelo, EJ, Landzberg, M, DeMaso, DR. Depression and anxiety in adults with congenital heart disease: a pilot study. Heart Lung 2003; 32: 105–110.CrossRefGoogle ScholarPubMed
15. Daliento, L, Mapelli, D, Russo, G, et al. Health related quality of life in adults with repaired tetralogy of Fallot: psychosocial and cognitive outcomes. Heart 2005; 91: 213–218.CrossRefGoogle ScholarPubMed
16. Berghammer, M, Karlsson, J, Ekman, I, Eriksson, P, Dellborg, M. Self-reported health status (EQ-5D) in adults with congenital heart disease. Int J Cardiol 2013; 165: 537–543.CrossRefGoogle ScholarPubMed
17. Freitas, IR, Castro, M, Sarmento, SL, et al. A cohort study on psychosocial adjustment and psychopathology in adolescents and young adults with congenital heart disease. BMJ Open 2013; 3: 1–8.CrossRefGoogle Scholar
18. Apers, S, Kovacs, AH, Luyckx, K, et al. Quality of life of adults with congenital heart disease in 15 countries: evaluating country-specific characteristics. J Am Coll Cardiol 2016; 67: 2237–2245.CrossRefGoogle ScholarPubMed
19. Parissis, J, Farmakis, D, Kadoglou, N, et al. Body mass index in acute heart failure: association with clinical profile, therapeutic management and in-hospital outcome. Eur J Heart Fail 2016; 18: 298–305.CrossRefGoogle ScholarPubMed
20. Clark, AL, Fonarow, GC, Horwich, TB. Obesity and the obesity paradox in heart failure. Prog Cardiovasc Dis 2014; 56: 409–414.CrossRefGoogle ScholarPubMed