title: Outcome of muscle and bone development in congenital heart disease.
abstract: Muscles and bones of patients with congenital heart disease (CHD) are subject to various potentially deleterious influences during growth. The aim of the present study was to analyse the outcome of bone and muscle parameters in adolescents and young adults with a spectrum of CHD. Bone and muscle parameters of the forearm were examined at two standard sites, 4% and 65%, in 29 adolescents and young adults with CHD, aged 14-24 years, by quantitative computed tomography. For the entire study population, bone and muscle parameters did not deviate significantly from the reference values except for age- and gender-corrected body height (ASDS-height: -0.6+/-1.2, p=0.01). Both age- and gender- and height- and gender-corrected (HSDS) abnormal bone mass (BMC) was found at the distal radius in patients with Fontan repair (ASDS-BMC4%: -1.5+/-0.9, p=0.008; HSDS-BMC4%: -1.2+/-1.0, p=0.05) and in those in NYHA class III (ASDS-BMC4%: -1.3+/-0.4, p=0.001; HSDS-BMC4%: -1.4+/-0.5, p=0.004). There was minimal overlap between Fontan patients (n=6) and NYHA class III (5 Fontan patients were in NYHA class I or II). In conclusion, most patients with CHD show a normal muscle and bone development in proportion to their reduced body height. Further follow-up is required to determine whether patients in a worse clinical status (NYHA III) and those with single ventricle physiology are at increased risk of osteoporosis and fractures.
authors.affiliation: Department of Pediatric Cardiology, University Hospital of Cologne, Joseph Stelzmann Strasse 9, 50924, Cologne, Germany. C.Witzel@gmx.de
authors.forename: Cordelia
authors.initials: C
authors.lastname: Witzel
authors.forename: Narayanswami
authors.initials: N
authors.lastname: Sreeram
authors.forename: Silke
authors.initials: S
authors.lastname: Coburger
authors.forename: Sabine
authors.initials: S
authors.lastname: Schickendantz
authors.forename: Konrad
authors.initials: K
authors.lastname: Brockmeier
authors.forename: Eckhard
authors.initials: E
authors.lastname: Schoenau
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001846:Bone Development / Q000502:physiology*; D016009:Chi-Square Distribution; D005260:Female; D005542:Forearm; D050723:Fractures, Bone / Q000209:etiology* / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D008297:Male; D009132:Muscles / Q000503:physiopathology*; D010024:Osteoporosis / Q000209:etiology* / Q000503:physiopathology; D010865:Pilot Projects; D012044:Regression Analysis