Impact of vitamin C on endothelial function and exercise capacity in patients with a Fontan circulation

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#adolescent #analysis-of-variance #antioxidants #ascorbic-acid #blood-pressure

Impact of vitamin C on endothelial function and exercise capacity in patients with a Fontan circulation

Goldstein et al., 2012 | Congenit Heart Dis | Rct

Citation

Goldstein Bryan H, Sandelin Angela M, ... Charpie John R. Impact of vitamin C on endothelial function and exercise capacity in patients with a Fontan circulation. Congenit Heart Dis. 2012;7(3):226-34. doi:10.1111/j.1747-0803.2011.00605.x

Abstract

OBJECTIVE: To evaluate the impact of antioxidant therapy on functional health status in Fontan-palliated patients. Design.  Prospective, randomized, double-blind, placebo-controlled trial. PATIENTS: Fifty-three generally asymptomatic Fontan patients. INTERVENTIONS: Patients were randomized to receive either high-dose ascorbic acid (vitamin C) or placebo for 4 weeks. OUTCOME MEASURES: Peripheral vascular function, as measured with endothelium-dependent digital pulse amplitude testing (EndoPAT), and exercise capacity were assessed before and after study drug treatment. Primary outcome measures included the EndoPAT index and peripheral arterial tonometry (PAT) ratio, both validated markers of vascular function. Secondary outcome measures included peak oxygen consumption and work. RESULTS: Twenty-three vitamin C- and 21 placebo-assigned subjects completed the protocol (83%). Median age and time from Fontan completion were 15 (interquartile range [IQR] 11.7-18.2) and 11.9 years (IQR 9.0-15.7), respectively. Right ventricular morphology was dominant in 30 (57%). Outcome measures were similar between groups at baseline. Among all subjects, vitamin C therapy was not associated with a statistical improvement in either primary or secondary outcome measures. In subjects with abnormal vascular function at baseline, compared with placebo, vitamin C therapy more frequently resulted in normalization of the EndoPAT index (45% vs. 17%) and PAT ratio (38% vs. 13%). CONCLUSIONS: Short-term therapy with vitamin C does not alter endothelial function or exercise capacity in an asymptomatic Fontan population overall. Vitamin C may provide benefit to a subset of Fontan patients with abnormal vascular function.

Key Findings

Twenty-three vitamin C- and 21 placebo-assigned subjects completed the protocol (83%). Median age and time from Fontan completion were 15 (interquartile range [IQR] 11.7-18.2) and 11.9 years (IQR 9.0-15.7), respectively. Right ventricular morphology was dominant in 30 (57%). Outcome measures were similar between groups at baseline. Among all subjects, vitamin C therapy was not associated with a statistical improvement in either primary or secondary outcome measures. In subjects with abnormal vas

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population abnormal vascular function at
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Adolescent
  • Analysis of Variance
  • Antioxidants
  • Ascorbic Acid
  • Blood Pressure
  • Child
  • Double-Blind Method
  • Endothelium, Vascular
  • Exercise Test
  • Exercise Tolerance
  • Female
  • Fontan Procedure
  • Heart Defects, Congenital
  • Heart Rate
  • Humans
  • Male
  • Manometry
  • Medication Adherence
  • Michigan
  • Oxygen Consumption
  • Palliative Care
  • Predictive Value of Tests
  • Prospective Studies
  • Time Factors
  • Treatment Outcome

Evidence Classification

  • Level: Rct
  • Publication Types: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
  • Vertical: vitamin-c-cardiovascular

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09