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Author Notes:

Correspondence to: Phillip T. Burch, MD, Division Cardiothoracic Surgery, Primary Children's Medical Center, 100 North Mario Capecchi Dr., Salt Lake City, UT 84113. E‐mail: Phillip.Burch@hsc.utah.edu

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Heart, Lung, and Blood Institute.

Disclosures: None

Subjects:

Research Funding:

Supported by U01 grants from the National Heart, Lung, and Blood Institute (HL068269, HL068270, HL068279, HL068281, HL068285, HL068292, HL068290, HL068288, HL085057).

Keywords:

  • growth
  • hypoplastic left heart syndrome
  • pediatrics
  • risk factors
  • Age Factors
  • Body Height
  • Child Development
  • Child, Preschool
  • Female
  • Humans
  • Hypoplastic Left Heart Syndrome
  • Infant
  • Infant, Newborn
  • Male
  • Norwood Procedures
  • Treatment Outcome
  • Weight Gain

Longitudinal assessment of growth in hypoplastic left heart syndrome: Results from the Single Ventricle Reconstruction Trial

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Journal Title:

Journal of the American Heart Association

Volume:

Volume 3, Number 3

Publisher:

, Pages e000079-e000079

Type of Work:

Article | Final Publisher PDF

Abstract:

Background-We sought to characterize growth between birth and age 3 years in infants with hypoplastic left heart syndrome who underwent the Norwood procedure. Methods and Results-We performed a secondary analysis using the Single Ventricle Reconstruction Trial database after excluding patients < 37 weeks gestation (N=498). We determined length-for-age z score (LAZ) and weight-for-age z score (WAZ) at birth and age 3 years and change in WAZ over 4 clinically relevant time periods. We identified correlates of change in WAZ and LAZ using multivariable linear regression with bootstrapping. Mean WAZ and LAZ were below average relative to the general population at birth (P < 0.001, P=0.05, respectively) and age 3 years (P < 0.001 each). The largest decrease in WAZ occurred between birth and Norwood discharge; the greatest gain occurred between stage II and 14 months. At age 3 years, WAZ and LAZ were < -2 in 6% and 18%, respectively. Factors associated with change in WAZ differed among time periods. Shunt type was associated with change in WAZ only in the Norwood discharge to stage II period; subjects with a Blalock-Taussig shunt had a greater decline in WAZ than those with a right ventricle-pulmonary artery shunt (P=0.002). Conclusions-WAZ changed over time and the predictors of change in WAZ varied among time periods. By age 3 years, subjects remained small and three times as many children were short as were underweight (> 2 SD below normal). Failure to find consistent risk factors supports the strategy of tailoring nutritional therapies to patient- and stage-specific targets.

Copyright information:

© 2014 The Authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/).

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