Key result
Following a standardised liquid meal, MR-proANP levels decreased by ~7% in patients with Fontan circulation but increased by ~8% in healthy volunteers.
Why the study?
Feeding significantly alters haemodynamics and hemodynamic responses to a meal differ between Fontan patients and normal subjects, which may alter cardiovascular biomarker kinetics.
Does the ingestion of a standardised liquid meal alter heart failure biomarker levels differently in patients with Fontan circulation compared to healthy volunteers?
Observational (n=30)
Does the ingestion of a standardised liquid meal alter heart failure biomarker levels differently in patients with Fontan circulation compared to healthy volunteers?
MR-proANP levels show contrary postprandial deflections in Fontan patients compared to healthy subjects, suggesting this biomarker should be measured under fasting conditions to avoid variability.
Answers are grounded in this paper and cite their sources.
Feeding status may affect biomarker interpretation in Fontan patients; leaves open whether postprandial kinetics differ from controls and requires prospective validation.
Background: Blood-based biomarkers reflecting different components of cardiovascular pathophysiology are now used increasingly in patients with Fontan circulation due to univentricular congenital heart disease. Feeding alters haemodynamics significantly and, thus, may affect biomarker levels. As the haemodynamic responses to a meal differ between Fontan patients and normal subjects, we hypothesised that biomarker kinetics may also vary between these populations. Methods: In 15 patients with Fontan physiology, and 15 matched healthy volunteers, 4 heart failure biomarkers were measured under fasting conditions, and 3 after additional timepoints over 2 h following ingestion of a standardised liquid meal. Changes in biomarker levels over time and the effect of Fontan physiology, sex and age were tested using repeated-measures mixed models. Results: Under fasting conditions, high-sensitivity C-reactive protein (hsCRP), mid-regional pro-adrenomedullin (MR-proADM) and C-terminal pro-endothelin-1 (CT-proET-1) were raised significantly in Fontan patients compared to controls. Postprandially, mid-regional pro-atrial natriuretic peptide (MR-proANP) decreased significantly in patients (max. mean decrease ∼7% after 120 min). Conversely, it increased in normal subjects (max. mean increase ∼8% after 60 min). The remaining biomarkers did not change significantly. Conclusions: The ingestion of food triggers contrary deflections of MR-proANP levels in patients with Fontan circulation compared to normal subjects. Therefore, this parameter should be assessed under fasting conditions in order to correct for postprandial variability.
No takes yet. Share an insight, caveat, or question.
Hauser et al. (2021) conducted an observational in Fontan circulation due to univentricular congenital heart disease (n=30). Fontan physiology vs. Healthy volunteers was evaluated on Postprandial change in mid-regional pro-atrial natriuretic peptide (MR-proANP). Following a standardised liquid meal, MR-proANP levels decreased by ~7% in patients with Fontan circulation but increased by ~8% in healthy volunteers.
Synapse has enriched 10 related papers. Consider them for comparative context: