ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
Fontan conduit cross-sectional area and relationship to exercise performance.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe synthetic extracardiac (EC) Fontan conduit may become inadequate as patients grow, potentially limiting cardiovascular capacity.
objectiveTo evaluate the relationship between EC-Fontan conduit cross-sectional area (CSA), indexed to body surface area (BSA), and exercise performance.
methodsA cross-sectional analysis of data from the Fontan Outcomes Registry using Clinical Examinations (FORCE) registry was performed. Patients with EC-Fontan anatomy who underwent cardiovascular magnetic resonance imaging (CMR) and cardiopulmonary exercise testing (CPET) within 1 year of each other were analyzed. Median length-averaged and minimum Fontan CSAs were measured using three-dimensional (3D) segmentation and indexed to BSA. The primary outcome was percent predicted peak VO₂ (ppVO₂) on maximal effort CPET. Multivariable linear regression models assessed associations between Fontan CSA/BSA and ppVO₂, adjusting for known predictors of ppVO₂ in Fontan patients.
resultsOf the 493 patients with an EC Fontan and with time-matched CMR and EST, 324 had technically adequate 3D imaging for Fontan conduit measurements and an appropriately documented maximal effort excercise stress test (EST). CMRs occurred at median age of 15 years old and median time of 11 years after Fontan surgery. The median length-averaged and minimum Fontan CSA were 268 mm
conclusionSmaller EC-Fontan CSA/BSA is independently associated with reduced exercise capacity after controlling for other known predictors of exercise performance.
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