Author + information
- Georges Ephrema,b,
- Amirhossein Esmaeelia,b,
- Jennifer Gerardina,b,
- Anita Sarafa,b,
- Salim Hayeka,b,
- Staci Jenningsa,b,
- Agasha Katabarwaa,b,
- Fred Rodrigueza,b,
- Arshed Quyyumia,b and
- Wendy Booka,b
Background: Fontan palliation results in late multi-organ co-morbidity. However, predictors of worse prognosis are lacking. We evaluated the association of red blood cell distribution width (RDW) with functional capacity and inflammatory biomarkers shown to be elevated in adult Fontan patients compared with age-matched controls.
Methods: Data from adult Fontan patients enrolled in a prospective registry were analyzed. RDW was assessed in relation to total distance walked on 6 minute walk test and biomarkers of general and pathway-specific inflammation. RDW greater than the upper limit of normal (14.4%) was considered elevated.
Results: Of the 79 patients (median age 29.5 years, 49% male, 19% black, 59% total cavopulmonary connection, and Fontan time 22 years) 31 (39%) had high RDW. Compared to low RDW, high RDW was associated with lower hemoglobin (14.4 g/dL vs 15.9 g/dL; p=0.011) and lower 6-minute walk distance (411 m vs 454 m, p=0.038) (Table part A). In the subgroup with biomarker data (n=22), high RDW correlated with higher levels of urokinase-type plasminogen activator receptor (sUPAR) compared to normal RDW (Table part B).
Conclusions: In this single center study of adult Fontan patients, high RDW was associated with poorer functional status and higher levels of sUPAR, an inflammatory biomarker. Studies with larger sample size are warranted to elucidate the prospect of this inexpensive, readily available biomarker in risk classification and prognostication of Fontan patients.
Moderated Poster Contributions
Congenital Heart Disease and Pulmonary Hypertension Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:10 a.m.
Session Title: Congenital Heart Disease: To the Third Decade and Beyond
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1131M-03
- 2017 American College of Cardiology Foundation