Abstract
Elevation in central venous pressure (CVP) plays a fundamental pathophysiologic role in Fontan circulation. Because there is no sub-pulmonary ventricle in this system, CVP also provides the driving force for pulmonary blood flow. We hypothesized that this would make Fontan patients more susceptible to even low-level elevation in pulmonary vascular resistance index (PVRI), resulting in greater systemic venous congestion and adverse outcomes. Adult Fontan patients and controls without congenital heart disease undergoing clinical evaluation that included cardiac catheterization and echocardiography were examined retrospectively. Outcomes including all-cause mortality and the development of Fontan associated diseases (FAD, defined as protein losing enteropathy, cirrhosis, heart failure hospitalization, arrhythmia, or thromboembolism) were assessed from longitudinal assessment. As compared to controls (n = 82), Fontan patients (n = 164) were younger (36 vs 45 years, p < 0.001), more likely to be on anticoagulation or antiplatelet therapy, and more likely to have atrial arrhythmia or cirrhosis. There was a strong correlation between CVP and PVRI in the Fontan group (r = 0.79, p < 0.001), but there was no such relationship in controls...Continue Reading
References
Jan 1, 1970·Cardiovascular Research·C G LaFarge, O S Miettinen
Jun 25, 2003·Circulation·S KhambadkoneA N Redington
Jul 31, 2004·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Max B MitchellMark M Boucek
Dec 12, 2007·Circulation·Paul KhairyMichael J Landzberg
Dec 21, 2007·Cardiology in the Young·Maria A BinottoAntonio A Lopes
Jun 7, 2008·European Heart Journal·Alessandro GiardiniFernando Maria Picchio
Nov 27, 2010·The Thoracic and Cardiovascular Surgeon·Y ZongtaoH Hongguang
Apr 27, 2012·Pediatric Cardiology·Jack RychikRebecca G Wells
Feb 12, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hideo OhuchiOsamu Yamada
Oct 1, 2013·The American Journal of Cardiology·Camden L HebsonWendy M Book
Mar 1, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ajay J IyengarUNKNOWN Australia and New Zealand Fontan Registry
May 24, 2014·The American Journal of Cardiology·Vanessa P M van EmpelBarry A Borlaug
Jul 7, 2014·Journal of the American College of Cardiology·Anitha S JohnFrank Cetta
Dec 3, 2014·Circulation·Anders HebertLars Søndergaard
Dec 4, 2014·European Journal of Heart Failure·Hua Zen LingDarlington O Okonko
Oct 10, 2015·Journal of the American College of Cardiology·Kavitha N PundiFrank Cetta
Jan 21, 2016·European Heart Journal·Werner BudtsAlexandra A Frogoudaki
Feb 18, 2016·International Journal of Cardiology·Gabriella AgnolettiCarlo Pace Napoleone
Mar 5, 2016·Congenital Heart Disease·Makoto MoriWendy M Book
May 26, 2016·Heart·Marc Gewillig, Stephen C Brown
Jul 9, 2016·International Journal of Cardiology·Alexander C EgbeNaser M Ammash
Jul 12, 2016·International Journal of Cardiology·Hiroki MoriToshio Nakanishi
Sep 17, 2016·Journal of the American College of Cardiology·Alexander C EgbeDavid J Driscoll
Jan 7, 2017·Heart·Tarek AlsaiedGruschen R Veldtman
Mar 12, 2017·The Journal of Thoracic and Cardiovascular Surgery·Gabriella AgnolettiLaura Bergamasco
Mar 13, 2017·International Journal of Cardiology·Alexander C EgbeHeidi M Connolly
Citations
Nov 19, 2019·Acta Paediatrica·Marc GewilligJack Rychik
Mar 20, 2020·Journal of the American Heart Association·Sushma ReddyGail Wright
Mar 19, 2020·Heart Failure Reviews·Christopher R BrodaAnitha S John
Jun 25, 2020·Pediatric Cardiology·Stevens CgKay J
Nov 1, 2020·Heart·Kathleen ColmanGruschen R Veldtman
May 15, 2021·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Hyun Woo GooDong Man Seo
Jun 19, 2021·Pediatric Cardiology·C G StevensR M Jacobsen
Aug 12, 2021·Cardiology in the Young·Ahmed KrimlyGruschen R Veldtman
Aug 24, 2021·Journal of Healthcare Engineering·Jinyou Chen, Yue Gao
Jul 1, 2021·ESC Heart Failure·Tarek AlsaiedGruschen R Veldtman
Dec 5, 2020·Journal of the American College of Cardiology·Alexander C EgbeBarry A Borlaug