3 February 2022
Fontan patients with only one functioning heart chamber often do not lead a carefree life despite very good chances of survival. They are sometimes unable to keep up with sporting activities and holiday trips have to be planned accordingly. High altitude stays in the mountains or during air travel can become a problem due to the altitude-related changes in the ambient air. Out of concern about potential dangers, patients therefore often do not participate as actively in everyday life as healthy people.
In order to research this problem and achieve an improvement in the quality of life of patients with Fontan's circulation, the DLR Institute of Aerospace Medicine is conducting a hypoxia study together with the University Hospital Bonn. Up to now, there has been insufficient medical research into the effects of an acute change in altitude on Fontan patients. In the study, the DLR, the University Hospital Bonn and the German Sport University Cologne, funded by the KinderHerz Foundation, are investigating how the cardiovascular system of these patients behaves during a longer stay at altitude. For this purpose, volunteers with stable Fontan circulation will spend three days and nights in April and May 2022 in the altitude chamber of the DLR aerospace medicine research facility :envihab in Cologne. An altitude of 2,500 m above sea level will be simulated and the influence of hypoxia (oxygen deficiency) on various cardiological and metabolic parameters will be investigated. Based on the results of the study, recommendations will be made in the long term on altitude stays and the resilience at altitude in Fontan patients.
"We are delighted to be conducting this study together with the UKB, the German Sport University Cologne and the KinderHerz Foundation, and to be able to contribute our extensive expertise in the field of sleep, cardiovascular and muscle to this particular study," says Prof. Dr Jens Tank, scientific director of the study on the part of the DLR Institute of Aerospace Medicine. "It would be a great development for medicine and the patients affected if we could contribute to a better understanding and, above all, better living conditions for those involved with our studies. The first trial run in our pressure chamber in :envihab with two patients was promising and we are very confident that the study will provide further meaningful data," says Tank.
"The aim of our joint study is to enable Fontan patients to organise their everyday lives and leisure time more freely and safely with the resulting findings. We would like to make young people's small and big dreams come true, such as being able to go on a trip to Australia," says Dr Nicole Müller, head of the study and senior physician in the Department of Paediatric Cardiology at Bonn University Hospital. "The study is a colourful mix of effort and fun, and the insights into the DLR's :envihab research centre, where astronauts such as Alexander Gerst or - very recently - Matthias Maurer usually carry out medical tests, are unique," says Dr Julian Härtel, assistant physician in the Department of Paediatric Cardiology at the University Hospital Bonn, who is leading the study together with Dr Müller.
At the end of July 2021, Hannah and Christian, two young Fontan patients, have already taken part in a test run. This has already made it possible to obtain initial examination results and optimise the processes of the individual examinations. The four-day programme includes a familiarisation day to get to know the study team and for the first preliminary examinations. During the three-day main study phase, in which a 24-hour high-altitude atmosphere is created, various parameters are examined by means of MRI examinations (magnetic resonance imaging), sleep examinations and physical stress examinations such as jumping strength measurements or a bicycle load. Between the examinations, the test persons then have time for joint leisure activities with the paediatric cardiologists who are present throughout or can retire to their individual rooms to rest.
The evaluations of the first examination results are already promising and all examinations proceeded without complications. However, for a meaningful study evaluation, a larger number of participants with at least 20 additional participants in small groups is necessary. Information on the conditions of participation, the time required and the compensation for expenses can be found at the following link. (German only)
(from left) Prof. Dr. Jens Tank, Head of Cardiovascular Aerospace Medicine DLR, Prof. Dr. Johannes Breuer, Director of the Centre for Paediatrics at the UKB, Hannah, participant in the preliminary study, Dr. Nicole Müller, study director and senior physician in the Department of Paediatric Cardiology at UKB, Christian, participant in the preliminary study and Dr Julian Härtel, study director and assistant physician in the Department of Paediatric Cardiology at UKB, during the preliminary study at the :envihab research facility of the DLR Institute of Aerospace Medicine in Cologne. © University Hospital Bonn (UKB)/J.F. Saba