ArticleJournal of the American Heart Association2025
Fontan-Associated Liver Disease: Trends Over Time and Relationship With Outcomes.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
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Who cites it
1 citing paper in PubMed.
- Limited association between liver stiffness and clinical outcomes in Fontan-associated liver disease: a retrospective analysis.International journal of cardiology. Congenital heart disease · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFontan associated liver disease is a poorly understood complication of long-term single ventricle palliation. This study sought to describe serial liver function changes in patients with a Fontan circulation from 2014 to 2020 and determine if these findings can be used to predict adverse clinical outcomes.
methodsWe conducted a retrospective chart review of Fontan patients age≥18 who were followed by a specialist clinic between 2014 and 2020. Annual bloodwork, including liver enzymes and AFP (alpha-fetoprotein), and liver imaging were analyzed. Common liver function scores were calculated. Trends over time and their correlation to clinical events were assessed. Events were defined as congestive heart failure, cardiac hospitalization, thrombosis, protein losing enteropathy, and death. The study assessed possible associations with the composite event of adverse outcomes.
resultsOne hundred twelve Fontan patients were included with a mean age of 24.9±8.1 years. Age-adjusted AFP and creatinine increased over the study period, whereas alkaline phosphatase decreased. There was no significant change in other liver biomarkers over the study period. The proportion of patients with higher liver imaging scores increased over the study period. Over a follow-up time of 6.1 years (95% control limit, 5.5-6.9 years), 44 (39.3%) patients experienced at least 1 event, most commonly cardiac hospitalization. In multivariable analysis, age was associated with a greater risk of events (hazard ratio, 1.035 [95% CI, 1.008-1.063];
conclusionsRoutine liver biomarkers do not increase over time despite increasing proportion of patients with higher liver imaging scores over the same time. Although our sample size was limited, current modalities to assess progression of liver dysfunction on bloodwork and imaging were not related to clinical outcomes.
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