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

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 el...

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Autores principales: Mohanakumar, Sheyanth, Kelly, Benjamin, Turquetto, Aida Luiza Ribeiro, Alstrup, Mathias, Amato, Luciana Patrick, Barnabe, Milena Schiezari Ru, Silveira, João Bruno Dias, Amaral, Fernando, Manso, Paulo Henrique, Jatene, Marcelo Biscegli, Hjortdal, Vibeke Elisabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165731/
https://www.ncbi.nlm.nih.gov/pubmed/34057301
http://dx.doi.org/10.14814/phy2.14862
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author Mohanakumar, Sheyanth
Kelly, Benjamin
Turquetto, Aida Luiza Ribeiro
Alstrup, Mathias
Amato, Luciana Patrick
Barnabe, Milena Schiezari Ru
Silveira, João Bruno Dias
Amaral, Fernando
Manso, Paulo Henrique
Jatene, Marcelo Biscegli
Hjortdal, Vibeke Elisabeth
author_facet Mohanakumar, Sheyanth
Kelly, Benjamin
Turquetto, Aida Luiza Ribeiro
Alstrup, Mathias
Amato, Luciana Patrick
Barnabe, Milena Schiezari Ru
Silveira, João Bruno Dias
Amaral, Fernando
Manso, Paulo Henrique
Jatene, Marcelo Biscegli
Hjortdal, Vibeke Elisabeth
author_sort Mohanakumar, Sheyanth
collection PubMed
description 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.
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spelling pubmed-81657312021-06-05 Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation Mohanakumar, Sheyanth Kelly, Benjamin Turquetto, Aida Luiza Ribeiro Alstrup, Mathias Amato, Luciana Patrick Barnabe, Milena Schiezari Ru Silveira, João Bruno Dias Amaral, Fernando Manso, Paulo Henrique Jatene, Marcelo Biscegli Hjortdal, Vibeke Elisabeth Physiol Rep Original Articles 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. John Wiley and Sons Inc. 2021-05-31 /pmc/articles/PMC8165731/ /pubmed/34057301 http://dx.doi.org/10.14814/phy2.14862 Text en © 2021 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Mohanakumar, Sheyanth
Kelly, Benjamin
Turquetto, Aida Luiza Ribeiro
Alstrup, Mathias
Amato, Luciana Patrick
Barnabe, Milena Schiezari Ru
Silveira, João Bruno Dias
Amaral, Fernando
Manso, Paulo Henrique
Jatene, Marcelo Biscegli
Hjortdal, Vibeke Elisabeth
Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation
title Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation
title_full Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation
title_fullStr Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation
title_full_unstemmed Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation
title_short Functional lymphatic reserve capacity is depressed in patients with a Fontan circulation
title_sort functional lymphatic reserve capacity is depressed in patients with a fontan circulation
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165731/
https://www.ncbi.nlm.nih.gov/pubmed/34057301
http://dx.doi.org/10.14814/phy2.14862
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