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dc.contributor.authorRosner, Assami
dc.contributor.authorDiab, Simone Goa
dc.contributor.authorMcElhinney, Doff B.
dc.contributor.authorFriedberg, Mark K.
dc.contributor.authorLui, George K.
dc.date.accessioned2023-03-13T12:18:06Z
dc.date.available2023-03-13T12:18:06Z
dc.date.issued2022-02-02
dc.description.abstractBackground - Morbidity and mortality increase as Fontan patients age into adulthood. Limited studies have examined cardiac magnetic resonance and echocardiographic parameters to predict death and transplantation in children after the Fontan operation. The aim of this study was to investigate echocardiographic parameters in adolescents and adults after Fontan operation, including myocardial mechanics such as classic-pattern dyssynchrony (CPD), as predictors of transplantation or death.<p> <p>Methods - In a cross-sectional retrospective study, strain analysis was performed on echocardiographic studies performed between 2001 and 2015 on 110 patients with single-ventricle physiology after the Fontan procedure. Strain curves were measured and visually assessed for the presence of CPD. The primary end point was death or transplantation after a follow-up period of 85 ± 35 months after echocardiography.<p> <p>Results - The median age at the date of echocardiography was 20 years (range, 3-45 years). Of 110 patients, 28 had undergone transplantation. During the study period, three patients died after transplantation and seven patients died without undergoing transplantation. CPD was seen in 16 and protein-losing enteropathy in 21 of 110 patients. On multivariate analysis, CPD (hazard ratio [HR], 9.4; 95% confidence interval [CI], 2.6-34.6), protein-losing enteropathy (HR, 10.6; 95% CI, 3.4-33.2), systolic blood pressure (HR, 0.954; 95% CI, 0.913-0.996), systolic/diastolic duration ratio (HR, 6.83; 95% CI, 1.33-35.0), and E-wave deceleration time (HR, 0.98; 95% CI, 0.97-0.99) were independently associated with the primary end point.<p> <p>Conclusions - CPD, protein-losing enteropathy, and systolic and diastolic ventricular dysfunction are significantly associated with transplantation or death in Fontan-operated patients. In selected patients, the presence of CPD may be a basis to investigate cardiac resynchronization therapy as a treatment strategy.en_US
dc.identifier.citationRosner A, Diab SG, McElhinney DB, Friedberg MK, Lui GK. Classic pattern dyssynchrony is associated with outcome in patients with Fontan circulation. Journal of the American Society of Echocardiography. 2022;35(5):513-522en_US
dc.identifier.cristinIDFRIDAID 2133175
dc.identifier.doi10.1016/j.echo.2022.01.012
dc.identifier.issn0894-7317
dc.identifier.issn1097-6795
dc.identifier.urihttps://hdl.handle.net/10037/28723
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.relation.journalJournal of the American Society of Echocardiography
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleClassic pattern dyssynchrony is associated with outcome in patients with Fontan circulationen_US
dc.type.versionacceptedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)