Research Mentor Name

Daisuke Kobayashi, MD, MPH, FAAP, FACC, FSCAI, FPICS

Research Mentor Email Address

Institution / Department

WSUSOM, Children's Hospital of Michigan

Document Type

Research Abstract

Research Type


Level of Research


Type of Post-Bachelor Degree




Background: Cardiopulmonary exercise testing (CPET) has been utilized for the management of children with congenital heart disease. Blood pressure (BP) response is one of the important markers that may carry a prognostic implication and has not been well studied in children who underwent Fontan operation.

Objective: The aims are to evaluate the incidence of abnormal BP response and the association between BP response and mortality/transplant at follow up in children undergoing Fontan operation.

Methods: This was the retrospective study of 114 children status post Fontan operation, who underwent treadmill CPET at Children’s Hospital of Michigan. The study duration was 11 years (2009 – 2019). BP response was categorized to normal and abnormal (including hypotensive, blunted and hypertensive responses). The primary outcome was mortality/transplant at follow-up. Kaplan-Meier survival curve analysis was used to evaluate the association.

Results: Normal BP response was observed most frequently (n=73, 64%). The most common abnormal BP response was a blunted response (n=29, 25%), followed by hypotensive response (n=11, 9.6%). There were no cases of hypertensive response. At the mean follow up of 1843 days (range 1641 – 2045 days), there was 8 death/transplant (7 %). In the Kaplan-Meier survival analysis, there was no statistically significant association between abnormal BP response and death/transplant.

Conclusion: Our data showed the incidence of normal and abnormal BP response with CPET in children undergoing Fontan operation. In our cohort, abnormal BP response did not carry a prognostic implication for Fontan patients.


Medicine and Health Sciences


Awarded 2021 MSRF for this project.