Native Spleen T1 Mapping for the Assessment of Hepatic Congestion in Children With Congenital Heart Disease.

Abstract

Background: Congestive hepatopathy in congenital heart disease (CHD) can lead to portal hypertension. Liver native T1 relaxation time (LT1) was reported to be associated with elevated central venous pressure and liver injury in CHD. This study investigated the utility of spleen native T1 relaxation time (ST1) in children with CHD, particularly those with Fontan circulation, and its association with hemodynamic parameters and biomarkers of liver injury.

Methods and results: This study included 120 patients with CHD (biventricular repair, 39; bidirectional Glenn shunt, 31; and Fontan circulation, 50) who underwent blood tests, cardiac catheterization, and cardiac magnetic resonance imaging performed within 48 h. Age-corrected ST1 (cST1; expressed as a percentage of normal) was calculated based on data from 22 control subjects (healthy children: no structural heart disease, normal cardiac function, normal systemic hemodynamics). cST1 was significantly correlated with net inferior vena cava (IVC) flow in both the overall cohort (r=0.364, P<0.001) and Fontan group (r=0.368, P<0.009). Multiple linear regression analysis showed that aspartate aminotransferase (AST) (P=0.011), LT1 (P=0.005), and net IVC flow (P=0.041) remained independent predictors of cST1 in the overall cohort, whereas AST (P<0.001) and non-alcoholic fatty liver disease fibrosis scores (P=0.029) were independent predictors in the Fontan group.

Conclusions: Age-corrected ST1 may serve as a non-invasive surrogate marker of systemic venous congestion and hepatic involvement in children with CHD.