ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2024
Characterization and z-score calculation of cardiovascular magnetic resonance imaging parameters in patients after the Fontan operation: A Fontan Outcome Registry using Cardiovascular Magnetic Resonance Examinations study.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Measuring atrioventricular valve regurgitation in Fontan patients using cardiovascular magnetic resonance imaging and the association with clinical outcomes: A FORCE Study.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2026Article
- Measuring Atrioventricular Valve Regurgitation Using 4D Flow Cardiovascular Magnetic Resonance Post-Fontan.Pediatric cardiology · 2026Article
- New strategies for valve replacement and interventional options in adults with congenital heart disease: new insights from Euro-ACHD 2025.European heart journal supplements : journal of the European Society of Cardiology · 2026Article
- Cardiac MRI in patients with Fontan circulation: assessing risk factors for adverse outcomes.Open heart · 2025Article
- Diastolic dysfunction in patients with Fontan palliation is associated with death and heart transplantation.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025Article
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Authors and funding
15 authors.
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Abstract
backgroundCardiac magnetic resonance (CMR) offers valuable hemodynamic insights post-Fontan, but is limited by the absence of normative single ventricle data. The Fontan Outcomes Registry using CMR Examinations (FORCE) is a large international Fontan-specific CMR registry. This study used FORCE registry data to evaluate expected CMR ventricular size/function and create Fontan-specific z-scores adjusting for ventricular morphology (VM) in healthier Fontan patients.
methods"Healthier" Fontan patients were defined as patients free of adverse outcomes, who are New York Heart Association class I, have mild or less valve disease, and <30% aortopulmonary collateral burden. General linear modeling was performed on 70% of the dataset to create z-scores for volumes and function. Models were tested using the remainder (30%) of the data. The z-scores were compared between children and adults. The z-scores were also compared between "healthier" Fontan and patients with adverse outcomes (death, listing for transplantation, or multiorgan disease).
resultsThe "healthier" Fontan population included 885 patients (15.0 ± 7.6 years) from 18 institutions with 1156 CMR examinations. Patients with left ventricle morphology had lower volume, mass and higher ejection fraction (EF) compared to right or mixed (two ventricles) morphology (p < 0.001 for all pairwise comparisons). Gender, body surface area, and VM were used in z-scores. Of the "healthier" Fontan patients, 647 were children <18 years and 238 were adults. Adults had lower ascending aorta flow (2.9 ± 0.7 vs 3.3 ± 0.8 L/min/m
conclusionThis is the first study to generate CMR z-scores post-Fontan. Importantly, the z-scores were generated and tested in "healthier" Fontan patients and both pediatric and adult Fontan patients. These equations may improve CMR-based risk stratification after the Fontan operation.
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