Acoustic radiation force impulse of the liver after Fontan operation: Correlation with cardiopulmonary exercise test

Congenital Heart Disease
Michael V Di MariaMichael R Narkewicz

Abstract

The current management paradigm for children with single ventricle heart disease involves a series of palliative surgeries, culminating in the Fontan operation. This physiology results in a high central venous pressure, and in the setting of single ventricle heart disease, results in hepatic injury and fibrosis over time. Fontan-associated liver disease (FALD) is universally present in this cohort, and the current gold standard for diagnosis remains biopsy. Noninvasive assessments of liver fibrosis, such as ultrasound with elastography or acoustic radiation force impulse (ARFI), has been utilized in this cohort. The effect of poor cardiovascular efficiency, as measured by cardiopulmonary exercise test (CPET), on assessments of liver fibrosis remains poorly understood. Retrospective, cross-sectional study. Subjects were evaluated in a multidisciplinary clinic setting for patients who have undergone Fontan operation. CPETs, liver ultrasound with elastography (ARFI), and standard laboratory tests were performed as part of routine clinical care pathway. Statistical analysis included linear correlation. There was a poor correlation between mean ARFI velocity and peak oxygen consumption (VO2max ) in this cohort (r = .20, P = NS). Sim...Continue Reading

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Citations

May 28, 2019·Expert Review of Gastroenterology & Hepatology·Haruki KomatsuTomoo Fujisawa
Jul 15, 2020·Ultrasonography·İlhan HekimsoySüha Süreyya Özbek

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