ArticleCJC open2020
Hepatic Venous Pressure Gradient in Fontan Physiology Has Limited Diagnostic and Prognostic Significance.
Article in CJC open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 27 citations in OpenAlex.
- Childhood Liver-Related Abnormalities After Fontan Completion: Evidence from a 20-Year Tertiary Centre Cohort.Pediatric cardiology · 2026Article
- A Dynamic 3D Human Liver Sinusoid Model for Mechanistic Interrogation of Fontan-Associated Liver Disease.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Differences in Prevalence and Severity of Liver Disease Between Lateral Tunnel and Extracardiac Conduit Fontan.JACC. Advances · 2026Article
- Prognostic biomarkers in Fontan associated liver disease.Translational pediatrics · 2026Review
- The Importance of Hepatic Surveillance After Single-Ventricle Palliation: An Interventional Study Validating Liver Elastography.Pediatric cardiology · 2026Article
- Fontan Circulation and Hepatic Venous Pressure Gradient: Are Bridging Collaterals One of the Weak Links?CJC pediatric and congenital heart disease · 2025Article
- Advances in Diagnostic and Interventional Catheterization in Adults with Fontan Circulation.Journal of clinical medicine · 2024Review
- Outcomes of Esophageal Varices in Adults With Fontan Palliation and Liver Cirrhosis.CJC pediatric and congenital heart disease · 2024Article
- Fontan-associated liver disease.Clinical liver disease · 2023Review
- Optimizing Referral Timing of Patients With Fontan Circulatory Failure for Heart Transplant.Transplantation proceedings · 2023Article
- Fontan-associated liver disease: Diagnosis, surveillance, and management.Frontiers in pediatrics · 2023Review
- Determinants and Prognostic Implications of Hepatorenal Dysfunction in Adults With Congenital Heart Disease.The Canadian journal of cardiology · 2022Article
- A Path FORWARD: Development of a Comprehensive Multidisciplinary Clinic to Create Health and Wellness for the Child and Adolescent with a Fontan Circulation.Pediatric cardiology · 2022Review
- Care Pattern for Fontan-Associated Liver Disease by Academic Pediatric Hepatologists in Canada.JPGN reports · 2022Article
- Invasive Hemodynamic Evaluation of the Fontan Circulation: Current Day Practice and Limitations.Current cardiology reports · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHepatic venous pressure gradient (HVPG) is measure of portal pressure and a prognostic tool in patients with viral and alcoholic cirrhosis; its utility is unknown in patients with Fontan-associated liver disease (FALD). Limited data suggest that patients with FALD have normal HVPG. On the basis of the available data, we hypothesized that there would be no association between HVPG, liver disease severity, and transplant-free survival in FALD.
methodsA retrospective study of Fontan patients who had liver biopsy and HVPG assessment at Mayo Clinic was performed. HVPG was calculated as wedged HVP minus free HVP; liver disease severity was measured by histologic assessment of fibrosis and standard clinical liver disease risk scores.
resultsOf 56 patients (aged 28 ± 7 years), the mean Fontan pressure was 16 ± 4 and the mean HVPG was 1.4 ± 0.3 mm Hg (range, 0-3). Perisinusoidal fibrosis and periportal fibrosis were present in 56 (100%) and 54 (94%) patients, respectively; 18 (32%) met criteria for cirrhosis. There was no correlation between HVPG and degree of hepatic fibrosis. Similarly, there was no correlation between HVPG and any clinical liver disease risk score. Six (11%) patients died and 2 (4%) underwent heart transplantation during follow-up; HVPG was not associated with transplant-free survival.
conclusionsHVPG is not elevated in FALD even in the setting of cirrhosis and does not correlate with liver disease severity or clinical outcomes. These results suggest the limited diagnostic and prognostic role of HVPG in the management of FALD and highlight the potential pitfalls of using HVPG in this population.
Identifiers
What OpenQuestion holds
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.