Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation

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art_MOHANAKUMAR_Functional_lymphatic_reserve_capacity_is_depressed_in_patients_2021.PDF (1.25 MB)
Citações na Scopus
11
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
MOHANAKUMAR, Sheyanth
KELLY, Benjamin
ALSTRUP, Mathias
AMARAL, Fernando
MANSO, Paulo Henrique
Citação
PHYSIOLOGICAL REPORTS, v.9, n.11, article ID e14862, 15p, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Lymphatic abnormalities play a role in effusions in individuals with a Fontan circulation. Recent results using near-infrared fluorescence imaging disclosed an increased contraction frequency of lymphatic vessels in Fontan patients compared to healthy controls. It is proposed that the elevated lymphatic pumping seen in the Fontan patients is necessary to maintain habitual interstitial fluid balance. Hyperthermia has previously been used as a tool for lymphatic stress test. By increasing fluid filtration in the capillary bed, the lymphatic workload and contraction frequency are increased accordingly. Using near-infrared fluorescence imaging, the lymphatic functional reserve capacity in Fontan patients were explored with a lymphatic stress test. Methods: Fontan patients (n = 33) were compared to a group of 15 healthy individuals of equal age, weight, and gender. The function of the superficial lymphatic vessels in the lower leg during rest and after inducing hyperthermia was investigated, using near-infrared fluorescence imaging. Results: Baseline values in the Fontan patients showed a 57% higher contraction frequency compared to the healthy controls (0.4 +/- 0.3 min-1 vs. 0.3 +/- 0.2 min(-1), p = 0.0445). After inducing stress on the lymphatic vessels with hyperthermia the ability to increase contraction frequency was decreased in the Fontan patients compared to the controls (0.6 +/- 0.5 min(-1) vs. 1.2 +/- 0.8 min(-1), p = 0.0102). Conclusions: Fontan patients had a higher lymphatic contraction frequency during normal circumstances. In the Fontan patients, the hyperthermia response is dampened indicating that the functional lymphatic reserve capacity is depressed. This diminished reserve capacity could be part of the explanation as to why some Fontan patients develop late-onset lymphatic complications.
Palavras-chave
Fontan circulation, lymphatic dysfunction, lymphatic reserve capacity, near-infrared fluorescence imaging
URI
https://observatorio.fm.usp.br/handle/OPI/41339
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - ODS/03