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Lower bone strength in young patients with Fontan circulation compared to controls
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0001-8443-9149
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0003-3281-7122
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
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2024 (English)In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: Previous reports indicate bone deficits in patients with Fontan circulation. However, the consequences of these deficits on bone strength and when these changes occur are unclear.

Aim: To compare the tibial bone strength-strain index between young patients (6-19 years) with Fontan circulation and age- and sex-matched controls, and to determine strength-strain-index in subgroups of children (6-12 years) and adolescents (13-19 years) versus controls.

Method: The tibia was examined with peripheral quantitative CT. Based on the assessed data, bone strength-strain index was calculated in the lateral and anterior-posterior directions.

Results: Twenty patients with Fontan and twenty controls (mean age 13.0 ± 4.4 years; 50% females) were examined. Patients had a lower strength-strain index in the lateral direction compared to controls (808.4 ± 416.8mm3 versus 1162.5 ± 552.1mm3, p = 0.043). Subgroup analyses showed no differences regarding strength-strain index in children (6-12 years) with Fontan circulation compared to controls. However, the adolescents (13-19 years) with Fontan circulation had lower strength-strain indexes in both the lateral and anterior-posterior directions compared to controls (1041.4 ± 299.8mm3 versus 1596.4 ± 239.6mm3, p < 0.001, and 771.7 ± 192.4mm3 versus 1084.9 ± 215.0mm3, p = 0.004). When adjusted for height, there were differences between patients (6-19 years) and controls in strength-strain indexes in both the lateral and anterior-posterior directions. In subgroup analyses, the results remained robust.

Conclusion: Young patients (6-19 years) with Fontan circulation have a lower strength-strain index in the tibia compared to controls. Subgroup analyses show that this deficit is mainly driven by the differences in adolescents (13-19 years), which might suggest that bone strength decreases with age.

Place, publisher, year, edition, pages
Cambridge University Press, 2024.
Keywords [en]
adolescents, bone mineral content, bone mineral density, CHD, children, Strength-strain index, total cavo-pulmonary connection
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-222429DOI: 10.1017/S1047951124000404PubMedID: 38450512Scopus ID: 2-s2.0-85187115758OAI: oai:DiVA.org:umu-222429DiVA, id: diva2:1845671
Funder
Swedish Heart Lung Foundation, 20160496Available from: 2024-03-19 Created: 2024-03-19 Last updated: 2024-03-19

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Wikner, AnnaJohansson, KarnaSthen Bergdahl, MagneHansson, LenaRydberg, AnnikaSandberg, Camilla

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Wikner, AnnaJohansson, KarnaSthen Bergdahl, MagneHansson, LenaRydberg, AnnikaSandberg, Camilla
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Cardiology in the Young
PediatricsPublic Health, Global Health, Social Medicine and Epidemiology

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