Yuen Lo Yau, Matthew S Purlee, Lindsey M Brinkley, Dipankar Gupta, David M Saulino, Dalia Lopez-Colon, John-Anthony Coppola, Dhanashree Rajderkar, Himesh Vyas
{"title":"紧张赛跑：Fontan患者肝硬度与超声弹性图和血流动力学的关系。","authors":"Yuen Lo Yau, Matthew S Purlee, Lindsey M Brinkley, Dipankar Gupta, David M Saulino, Dalia Lopez-Colon, John-Anthony Coppola, Dhanashree Rajderkar, Himesh Vyas","doi":"10.32604/chd.2025.065661","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with Fontan physiology are predisposed to congestive hepatopathy, progressive liver fibrosis, and end-stage liver disease. Ultrasound-based shear wave elastography (SWE) is a non-invasive tool to diagnose and monitor liver fibrosis. We sought to determine whether the degree of hemodynamic derangement prior to and after the Fontan operation is associated with increased liver stiffness measured by SWE.</p><p><strong>Methods: </strong>A single-center retrospective study of patients with Fontan circulation who underwent ultrasound elastography between 2008 and 2024 was conducted. Liver stiffness was measured by SWE and reported as velocity in m/s. Hemodynamic assessment with cardiac catheterization and echocardiograms were collected before and after the Fontan operation. Data was analyzed as a continuous (linear regression model) and a dichotomous variable (<i>t</i>-test).</p><p><strong>Results: </strong>78 post-Fontan ultrasound elastography studies performed in 56 patients were analyzed. Pre-Fontan hemodynamics included median effective pulmonary flow of 2.45 L/min/m<sup>2</sup> [2.21, 3.16] (<i>p</i> = 0.46), ventricular end-diastolic pressure of 10 mmHg [8, 10.5] (<i>p</i> = 0.77), and median Glenn pressure of 12 mmHg [13, 15] (<i>p</i> = 0.83). Post-Fontan median systemic cardiac index was 2.80 L/min/m<sup>2</sup> [2.4, 3.34] (<i>p</i> = 0.93), median ventricular end-diastolic pressure of 12 mmHg [13.5, 14] (<i>p</i> = 0.99), median systemic saturation of 93% [87, 96] (<i>p</i> = 0.77), median indexed pulmonary vascular resistance of 1.80 WU·m<sup>2</sup> [1.49, 2.37] (<i>p</i> = 0.93), and median Fontan pressure of 18 mmHg [16, 21] (<i>p</i> = 0.86). No correlation was found between SWE and hemodynamics. On echocardiography, no correlation was found between SWE and systemic ventricular systolic function (<i>p</i> = 0.35) or degree of systemic atrioventricular valve regurgitation (<i>p</i> = 0.35).</p><p><strong>Conclusions: </strong>The degree of liver stiffness by SWE in this cohort did not correlate with pre- and post-Fontan hemodynamics on cardiac catheterization, degree of ventricular dysfunction, or severity of atrioventricular valve regurgitation by echocardiography.</p>","PeriodicalId":10666,"journal":{"name":"Congenital Heart Disease","volume":"20 2","pages":"265-272"},"PeriodicalIF":0.3000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097783/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Tense Race: Correlation of Liver Stiffness with Ultrasound Elastography and Hemodynamics in Fontan Patients.\",\"authors\":\"Yuen Lo Yau, Matthew S Purlee, Lindsey M Brinkley, Dipankar Gupta, David M Saulino, Dalia Lopez-Colon, John-Anthony Coppola, Dhanashree Rajderkar, Himesh Vyas\",\"doi\":\"10.32604/chd.2025.065661\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Patients with Fontan physiology are predisposed to congestive hepatopathy, progressive liver fibrosis, and end-stage liver disease. Ultrasound-based shear wave elastography (SWE) is a non-invasive tool to diagnose and monitor liver fibrosis. We sought to determine whether the degree of hemodynamic derangement prior to and after the Fontan operation is associated with increased liver stiffness measured by SWE.</p><p><strong>Methods: </strong>A single-center retrospective study of patients with Fontan circulation who underwent ultrasound elastography between 2008 and 2024 was conducted. Liver stiffness was measured by SWE and reported as velocity in m/s. Hemodynamic assessment with cardiac catheterization and echocardiograms were collected before and after the Fontan operation. Data was analyzed as a continuous (linear regression model) and a dichotomous variable (<i>t</i>-test).</p><p><strong>Results: </strong>78 post-Fontan ultrasound elastography studies performed in 56 patients were analyzed. Pre-Fontan hemodynamics included median effective pulmonary flow of 2.45 L/min/m<sup>2</sup> [2.21, 3.16] (<i>p</i> = 0.46), ventricular end-diastolic pressure of 10 mmHg [8, 10.5] (<i>p</i> = 0.77), and median Glenn pressure of 12 mmHg [13, 15] (<i>p</i> = 0.83). Post-Fontan median systemic cardiac index was 2.80 L/min/m<sup>2</sup> [2.4, 3.34] (<i>p</i> = 0.93), median ventricular end-diastolic pressure of 12 mmHg [13.5, 14] (<i>p</i> = 0.99), median systemic saturation of 93% [87, 96] (<i>p</i> = 0.77), median indexed pulmonary vascular resistance of 1.80 WU·m<sup>2</sup> [1.49, 2.37] (<i>p</i> = 0.93), and median Fontan pressure of 18 mmHg [16, 21] (<i>p</i> = 0.86). No correlation was found between SWE and hemodynamics. On echocardiography, no correlation was found between SWE and systemic ventricular systolic function (<i>p</i> = 0.35) or degree of systemic atrioventricular valve regurgitation (<i>p</i> = 0.35).</p><p><strong>Conclusions: </strong>The degree of liver stiffness by SWE in this cohort did not correlate with pre- and post-Fontan hemodynamics on cardiac catheterization, degree of ventricular dysfunction, or severity of atrioventricular valve regurgitation by echocardiography.</p>\",\"PeriodicalId\":10666,\"journal\":{\"name\":\"Congenital Heart Disease\",\"volume\":\"20 2\",\"pages\":\"265-272\"},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097783/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Congenital Heart Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.32604/chd.2025.065661\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Congenital Heart Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.32604/chd.2025.065661","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/30 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
A Tense Race: Correlation of Liver Stiffness with Ultrasound Elastography and Hemodynamics in Fontan Patients.
Background: Patients with Fontan physiology are predisposed to congestive hepatopathy, progressive liver fibrosis, and end-stage liver disease. Ultrasound-based shear wave elastography (SWE) is a non-invasive tool to diagnose and monitor liver fibrosis. We sought to determine whether the degree of hemodynamic derangement prior to and after the Fontan operation is associated with increased liver stiffness measured by SWE.
Methods: A single-center retrospective study of patients with Fontan circulation who underwent ultrasound elastography between 2008 and 2024 was conducted. Liver stiffness was measured by SWE and reported as velocity in m/s. Hemodynamic assessment with cardiac catheterization and echocardiograms were collected before and after the Fontan operation. Data was analyzed as a continuous (linear regression model) and a dichotomous variable (t-test).
Results: 78 post-Fontan ultrasound elastography studies performed in 56 patients were analyzed. Pre-Fontan hemodynamics included median effective pulmonary flow of 2.45 L/min/m2 [2.21, 3.16] (p = 0.46), ventricular end-diastolic pressure of 10 mmHg [8, 10.5] (p = 0.77), and median Glenn pressure of 12 mmHg [13, 15] (p = 0.83). Post-Fontan median systemic cardiac index was 2.80 L/min/m2 [2.4, 3.34] (p = 0.93), median ventricular end-diastolic pressure of 12 mmHg [13.5, 14] (p = 0.99), median systemic saturation of 93% [87, 96] (p = 0.77), median indexed pulmonary vascular resistance of 1.80 WU·m2 [1.49, 2.37] (p = 0.93), and median Fontan pressure of 18 mmHg [16, 21] (p = 0.86). No correlation was found between SWE and hemodynamics. On echocardiography, no correlation was found between SWE and systemic ventricular systolic function (p = 0.35) or degree of systemic atrioventricular valve regurgitation (p = 0.35).
Conclusions: The degree of liver stiffness by SWE in this cohort did not correlate with pre- and post-Fontan hemodynamics on cardiac catheterization, degree of ventricular dysfunction, or severity of atrioventricular valve regurgitation by echocardiography.
期刊介绍：
Congenital Heart Disease is an open-access journal focusing on congenital heart disease in children and adults. Though the number of infants born with heart disease each year is relatively small (approximately 1% of the population), advances in treating such malformations have led to increased life spans for this population. Consequently, today most patients treated for congenital heart disease are over the age of 20. What are the special needs of adults with congenital heart disease? What are the latest developments in the care of the fetus, infants, and children? Who should treat these patients? How should they be treated?
Congenital Heart Disease focuses on these questions and more. Conceived as a forum for the most up-to-date information on congenital heart disease, the journal is led by Editor-in-Chief Vladimiro L. Vida, MD, Ph.D., Professor in Cardiac Surgery, University of Padua in Italy, as well as an international editorial board. Congenital Heart Disease publishes articles on heart disease as it relates to the following areas:
• Basic research of congenital heart disease
• Clinical pediatric and adult cardiology
• Cardiac imaging
• Preventive cardiology
• Diagnostic and interventional cardiac catheterization
• Electrophysiology
• Surgery
• Long-term follow-up, particularly as it relates to older children and adult congenital heart disease
• Exercise and exercise physiology in the congenital patient
• Post-op and critical care
• Common disorders such as syncope, chest pain, murmurs, as well as acquired disorders such as Kawasaki syndrome
The journal includes clinical studies, invited editorials, state-of-the-art reviews, case reports, articles focusing on the history and development of congenital heart disease, and CME material. Occasional issues focus on special topics.
Readership: Congenital Heart Disease was created for pediatric cardiologists; adult cardiologists who care for patients with congenital heart disease; pediatric and pediatric cardiology nurses; surgeons; radiologists; anesthesiologists; critical care physicians and nurses; and adult support staff involved in the care of patients with congenital heart disease.
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