ArticleInternational journal of cardiology2020
Biomarker profile in stable Fontan patients.
Article in International journal of cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06731322 (Gut, Inflammation and Nutrition in Adult Patients After Fontan Operation), which is not on this map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Gut, Inflammation and Nutrition in Adult Patients After Fontan Operation (GIN-Fontan Study)
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Fontan Circulation Associated Organ Abnormalities Beyond the Heart, Lungs, Liver, and Gut: A Systematic Review.Frontiers in cardiovascular medicine · 2022Pooled it
- Decreased Endothelial Cell Retinoic Acid Signaling Accelerates Progression of Single Ventricle Pulmonary Vascular Malformations.JACC. Basic to translational science · 2026Article
- Single-cell spatial transcriptomics reveals hepatocyte reprogramming in Fontan-associated liver disease.JCI insight · 2026Article
- NT-proBNP and other blood biomarkers in patients after Fontan Surgery: Prognostic, diagnostic, and management implications.International journal of cardiology. Congenital heart disease · 2026Article
- Long-Term Care in Fontan Circulation: Surveillance and Management of Fontan-Associated Liver Disease and Protein-Losing Enteropathy.Current cardiology reports · 2026Review
- Deep learning for vessel segmentation and flow analysis to identify clusters associated with adverse outcomes in a fontan patient registry.Scientific reports · 2026Article
- Fontan associated protein-losing enteropathy is linked to distinct metabolic and hepatic alterations.Scientific reports · 2026Article
- Correlation of Liver Fibrosis on Ultrasound Elastography and Liver Biopsy After Fontan Operation: Is Non-invasive Always Better?Pediatric cardiology · 2026Article
- Untargeted Serum Proteomics in the Fontan Circulation Reveals Three Distinct Molecular Signatures of Fontan Physiology with CYB5R3 Among Key Proteins.International journal of molecular sciences · 2026Article
- Long-term survival and complications of Fontan patients: where do we stand?American journal of cardiovascular disease · 2026Review
- Insulin Resistance after Fontan Palliation.Pediatric cardiology · 2025Article
- Circulating Biomarkers in Failing Fontan Circulation: Current Evidence and Future Directions.Journal of cardiovascular development and disease · 2025Review
- Pathophysiology of endothelial dysfunction in Fontan circulation: from bench to bedside and back again.Angiogenesis · 2025Review
- The Cardiohepatic Axis in Heart Failure.JACC. Basic to translational science · 2025Review
- Systemic Changes in Adults With a Fontan Circulation: Insights From the Plasma Proteome.Journal of the American Heart Association · 2025Article
- One Ventricle, 3000 Proteins: Unraveling the Molecular Landscape of the Fontan Circulation.Journal of the American Heart Association · 2025Article
- Blood Biomarkers as a Non-Invasive Method for the Assessment of the State of the Fontan Circulation.Journal of clinical medicine · 2025Review
- A Tense Race: Correlation of Liver Stiffness with Ultrasound Elastography and Hemodynamics in Fontan Patients.Congenital heart disease · 2025Article
- Transcriptomic analysis of circulating extracellular vesicles during the perioperative period of Fontan and Glenn surgery.NPJ cardiovascular health · 2024Article
- Deterioration in Renal Function in Patients With a Fontan Circulation and Association With Mortality.JACC. Advances · 2024Article
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAs the population of adults with congenital heart disease (CHD) grows, cardiologists continue to encounter patients with complex anatomies that challenge the standard treatment of care. Single ventricle Fontan palliated patients are the most complex within CHD, with a high morbidity and mortality burden. Factors driving this early demise are largely unknown. METHODS AND
resultsWe analyzed biomarker expression in 44 stable Fontan outpatients (29.2 ± 10.7 years, 68.2% female) seen in the outpatient Emory Adult Congenital Heart Center and compared them to 32 age, gender and race matched controls. In comparison to controls, Fontan patients had elevated levels of multiple cytokines within the inflammatory pathway including Tumor Necrosis Factor-α (TNF-α) (p < 0.001), Interleukin-6 (IL-6) (p < 0.011), Growth Derived Factor-15 (GDF-15) (p < 0.0001), β2-macroglobulin, (p = 0.0006), stem cell mobilization: Stromal Derived Factor-1∝ (SDF-1α) (p = 0.006), extracellular matrix turnover: Collagen IV (p < 0.0001), neurohormonal activation: Renin (p < 0.0001), renal dysfunction: Cystatin C (p < 0.0001) and Urokinase Receptor (uPAR) (p = 0.022), cardiac injury: Troponin-I (p < 0.0004) and metabolism: Adiponectin (p = 0.0037). Within 1 year of enrollment 50% of Fontan patients had hospitalizations, arrhythmias or worsening hepatic function. GDF-15 was significantly increased in Fontan patients with clinical events (p < 0.0001). In addition, GDF-15 moderately correlated with longer duration of Fontan (r = 0.55, p = 0.01) and was elevated in atriopulmonary (AP) Fontan circulation. Finally, in a multivariate model, VEGF-D and Collagen IV levels were found to be associated with a change in MELDXI, a marker of liver dysfunction.
conclusionMultiple clinical and molecular biomarkers are upregulated in Fontan patients, suggesting a state of chronic systemic dysregulation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.