CMR-Derived Ventricular Global Function Index in Patients Late After the Fontan Operation

Alsaied, Tarek; Critser, Paul J.; Azcue, Nina; Clair, Nicole St.; Powell, A.; Rathod, Rahul H.

doi:10.1016/j.jcmg.2020.06.011

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…The SVGFI was calculated as: (ventricular stroke volume Â 100) / (ventricular mean cavity volume þ total ventricular myocardial volume) (10). Ventricular (A and B) The contours for analysis for longitudinal and circumferential strain, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Several risk factors for death or heart transplant have been identified, including clinical parameters, such as history of protein-losing enteropathy (3) and congestive heart failure (4,5). Reported ventricular parameters associated with this endpoint include right-dominant ventricular morphology (6,7), increased indexed end-diastolic volume (EDV i ) of the functional single ventricle (8), increased ventricular mass, worse ventricular strain (9), and worse functional single ventricle global function index (SVGFI) (10). Cardiac magnetic resonance (CMR) remains the preferred modality for the assessment of ventricular size and function in these patients (11).…”

mentioning

confidence: 99%

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Integrated Clinical and Magnetic Resonance Imaging Assessments Late After Fontan Operation

Clair

Powell

Geva

et al. 2021

Journal of the American College of Cardiology

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Integrated Clinical and Magnetic Resonance Imaging Assessments Late After Fontan Operation

Clair

Powell

Geva

et al. 2021

Journal of the American College of Cardiology

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“…In a cohort of adult patients with atherosclerosis, GFI provided improved prediction of composite adverse outcomes (CAO) compared with EF [ 9 , 10 ]. In patients with congenital heart disease, GFI has been associated with exercise capacity in repaired tetralogy of Fallot [ 11 ] and Fontan patients [ 12 ]. In the Fontan cohort, GFI showed an association with Fontan failure while EF did not [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…In patients with congenital heart disease, GFI has been associated with exercise capacity in repaired tetralogy of Fallot [ 11 ] and Fontan patients [ 12 ]. In the Fontan cohort, GFI showed an association with Fontan failure while EF did not [ 12 ]. However, no studies have assessed the relationship between GFI and CAO in the pediatric PH population.…”

Section: Introductionmentioning

confidence: 99%

Ventricular global function index is associated with clinical outcomes in pediatric pulmonary hypertension

Critser

Schäfer

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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Background Multiple right ventricular (RV) metrics have prognostic value in pulmonary hypertension (PH). A cardiac magnetic resonance imaging (CMR) derived global ventricular function index (GFI) provided improved prediction of composite adverse outcome (CAO) in adults with atherosclerosis. GFI has not yet been explored in a PH population. We explored the feasibility of GFI as a predictor of CAO in a pediatric PH population. Methods Two center retrospective chart review identified pediatric PH patients undergoing CMR from Jan 2005–June 2021. GFI, defined as the ratio of the stroke volume to the sum of mean ventricular cavity and myocardial volume, was calculated for each patient. CAO was defined as death, lung transplant, Potts shunt, or parenteral prostacyclin initiation after CMR. Cox proportional hazards regression was used to estimate associations and assess model performance between CMR parameters and CAO. Results The cohort comprised 89 patients (54% female, 84% World Health Organization (WHO) Group 1; 70% WHO-FC ≤ 2; and 27% on parenteral prostacyclin). Median age at CMR was 12 years (IQR 8.1–17). Twenty-one (24%) patients experienced CAO during median follow up of 1.5 years. CAO cohort had higher indexed RV volumes (end systolic—145 vs 99 mL/m2, p = 0.003; end diastolic—89 vs 46 mL/m2, p = 0.004) and mass (37 vs 24 gm/m2, p = 0.003), but lower ejection fraction (EF) (42 vs 51%, p < 0.001) and GFI (40 vs 52%, p < 0.001). Higher indexed RV volumes (hazard ratios [HR] 1.01, CI 1.01–1.02), lower RV EF (HR 1.09, CI 1.05–1.12) and lower RV GFI (HR 1.09, CI 1.05–1.11) were associated with increased risk of CAO. In survival analysis, patients with RV GFI < 43% demonstrated decreased event-free survival and increased hazard of CAO compared to those with RV GFI ≥ 43%. In multivariable models, inclusion of GFI provided improved prediction of CAO compared to models incorporating ventricular volumes, mass or EF. Conclusions RV GFI was associated with CAO in this cohort, and inclusion in multivariable models had increased predictive value compared to RVEF. GFI uses readily available CMR data without additional post-processing and may provide additional prognostic value in pediatric PH patients beyond traditional CMR markers.

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Lower Child Opportunity Index is Associated with Lower Exercise Capacity Post-Fontan Palliation

Karolcik,

Wang,

Ragavan

et al. 2024

Pediatr Cardiol

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CMR-Derived Ventricular Global Function Index in Patients Late After the Fontan Operation

Cited by 7 publications

References 4 publications

Integrated Clinical and Magnetic Resonance Imaging Assessments Late After Fontan Operation

Integrated Clinical and Magnetic Resonance Imaging Assessments Late After Fontan Operation

Ventricular global function index is associated with clinical outcomes in pediatric pulmonary hypertension

Lower Child Opportunity Index is Associated with Lower Exercise Capacity Post-Fontan Palliation

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