PP454 - COMPREHENSIVE NUTRITIONAL ASSESSMENT IN ADULTS AFTER FONTAN OPERATION

PP454

COMPREHENSIVE NUTRITIONAL ASSESSMENT IN ADULTS AFTER FONTAN OPERATION

A. Kuzmanovski^1,*, E. Benedik², N. Pavšič³

¹Dietetics and Nutrition Service, University Medical Centre Ljubljana, ²Human Nutrition, Biotechnical Faculty, University of Ljubljana, ³Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia

Rationale: Adults after Fontan operation are characterized by multiorgan dysfunction that may adversely affect nutritional status. However, data in this population remain limited, and we aimed to provide a comprehensive assessment of nutritional status compared with healthy controls.

Methods: This single-centre prospective study included adult patients after Fontan operation without protein-losing enteropathy and age and sex matched healthy controls (GIN-Fontan study; NCT06731322). All participants underwent a standardized assessment including body composition by bioelectrical impedance analysis (BIA), muscle strength by handgrip dynamometry and resting energy expenditure (REE) by indirect calorimetry. Levels of eleven micronutrients were measured. Malnutrition was diagnosed according to Global Leadership Initiative on Malnutrition criteria. Overweight and obesity were defined using body mass index (BMI).

Results: Twenty-six patients after Fontan operation (27±6 years, 46% women) and 13 controls were included, with no significant differences in age, sex, or BMI between groups. Patients had lower fat-free mass percentage, higher fat mass percentage, and lower phase angle than controls. Handgrip strength was lower in patients after age and sex adjustment. REE did not differ between groups. Patients after Fontan operation had lower circulating levels of iron, vitamin A, D, and E. Nutritional disorders were more prevalent in patients after Fontan operation (69% vs 31%, p=0.039), with 50% classified as overweight or obese and 19% meeting criteria for malnutrition.

Conclusion: Adults after Fontan operation exhibit altered body composition, reduced muscle strength, and micronutrient deficiencies despite similar REE compared to healthy controls. Nutritional disorders in this population are common and may not be detected by BMI alone. Comprehensive nutritional assessment should be part of routine clinical follow-up of adults after Fontan operation.

Disclosure of Interest: None declared