Atrial function in Fontan patients assessed by CMR: Relation with exercise capacity and long-term outcomes.

International Journal of Cardiology
Jelle P G van der VenW A Helbing

Abstract

To assess the role of atrial function on exercise capacity and clinical events in Fontan patients. We included 96 Fontan patients from 6 tertiary centers, aged 12.8 (IQR 10.1-15.6) years, who underwent cardiac magnetic resonance imaging and cardiopulmonary exercise testing within 12 months of each other from 2004 to 2017. Intra-atrial lateral tunnel (ILT) and extracardiac conduit (ECC) patients were matched 1:1 with regard to age, gender and dominant ventricle. The pulmonary venous atrium was manually segmented in all phases and slices. Atrial function was assessed by volume-time curves. Furthermore, atrial longitudinal and circumferential feature tracking strain was assessed. We determined the relation between atrial function and exercise capacity, assessed by peak oxygen uptake and VE/VCO2 slope, and events (mortality, listing for transplant, re-intervention, arrhythmia) during follow-up. Atrial maximal and minimal volumes did not differ between ILT and ECC patients. ECC patients had higher reservoir function (21.1 [16.4-28.0]% vs 18.2 [10.9-22.2]%, p = .03), lower conduit function and lower total circumferential strain (13.8 ± 5.1% vs 18.0 ± 8.7%, p = .01), compared to ILT patients. Only for ECC patients, a better late peak ...Continue Reading

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Citations

Aug 6, 2020·The International Journal of Cardiovascular Imaging·Paul J CritserTarek Alsaied
Jul 11, 2021·The International Journal of Cardiovascular Imaging·Arend D J Ten Harkel, Annelies E Van der Hulst
May 31, 2021·The International Journal of Cardiovascular Imaging·Gruschen VeldtmanOlga Vriz

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