scholarly journals Cardiac magnetic resonance-derived Cardiac Index is associated with adverse outcomes in patients with single-ventricle Fontan circulation: a preliminary study

2021 ◽  
Author(s):  
Małgorzata Kowalczyk ◽  
Piotr Zieliński ◽  
Magdalena Marczak ◽  
Katarzyna Kożuch ◽  
Magdalena Lipczyńska ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Index ◽  
Single Ventricle ◽  
Fontan Circulation ◽  
Adverse Outcomes ◽  
Preliminary Study

Developing an adolescent and adult Fontan Management Programme

2021 ◽  
pp. 1-6
Author(s):  
Adam M. Lubert ◽  
Tarek Alsaied ◽  
Andrew T. Trout ◽  
Jonathan R. Dillman ◽  
Joseph J. Palermo ◽  
...  
Keyword(s):  
Single Ventricle ◽  
Fontan Procedure ◽  
Multiple Organ ◽  
Fontan Circulation ◽  
Management Programme ◽  
Adverse Outcomes ◽  
Cardiac Complications ◽  
Organ Systems ◽  
Adolescents And Adults ◽  
Care Models

Abstract Patients with single-ventricle CHD undergo a series of palliative surgeries that culminate in the Fontan procedure. While the Fontan procedure allows most patients to survive to adulthood, the Fontan circulation can eventually lead to multiple cardiac complications and multi-organ dysfunction. Care for adolescents and adults with a Fontan circulation has begun to transition from a primarily cardiac-focused model to care models, which are designed to monitor multiple organ systems, and using clues from this screening, identify patients who are at risk for adverse outcomes. The complexity of care required for these patients led our centre to develop a multidisciplinary Fontan Management Programme with the primary goals of earlier detection and treatment of complications through the development of a cohesive network of diverse medical subspecialists with Fontan expertise.

scholarly journals EPICARDIAL ADIPOSE TISSUE EVALUATED BY CARDIAC MAGNETIC RESONANCE PREDICTS ADVERSE OUTCOMES IN HEART FAILURE PATIENTS

2020 ◽  
Vol 75 (11) ◽  
pp. 1080
Author(s):  
Reza Mohebi ◽  
Carlos Santos-Gallego ◽  
Darian de Luna ◽  
Kenny Daici ◽  
Juan Antonio Requena Ibanez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adipose Tissue ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Epicardial Adipose Tissue ◽  
Adverse Outcomes ◽  
Heart Failure Patients

Abnormalities in serum biomarkers correlate with lower cardiac index in the Fontan population

2016 ◽  
Vol 27 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Bradley S. Marino ◽  
David J. Goldberg ◽  
Adam L. Dorfman ◽  
Eileen King ◽  
Heidi Kalkwarf ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Index ◽  
Mean Corpuscular Volume ◽  
Operating Characteristic ◽  
Risk Group ◽  
Area Under The Curve ◽  
Total Alkaline Phosphatase ◽  
Fontan Patients ◽  
Total Alkaline

BackgroundFontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.Methods and resultsThis study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2versus lower-risk group=2.96 L/minute/m2, (p<0.01)].ConclusionsHigher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.

Cardiac magnetic resonance derived atrial function in patients with a Fontan circulation

2020 ◽  
Author(s):  
Paul J. Critser ◽  
Vien Truong ◽  
Adam W. Powell ◽  
Hassan Almeneisi ◽  
Alexander R. Opotowsky ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Fontan Circulation ◽  
Atrial Function

Abstract 15441: Determining the Optimal Thresholds for Classifying Functional Mitral Regurgitation Severity by Cardiac Magnetic Resonance Imaging in Patients With Non-ischemic Cardiomyopathy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Tom Kai Ming Wang ◽  
Harry Choi ◽  
Duygu Kocyigit ◽  
Alex Milinovich ◽  
Jian Jin ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Mitral Regurgitation ◽  
Primary Endpoint ◽  
Ischemic Cardiomyopathy ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Functional Mitral Regurgitation ◽  
Valvular Regurgitation ◽  
Predictive Values

Background: Functional mitral regurgitation (MR) grading by echocardiography is often challenging, and cardiac magnetic resonance (CMR) may provide more accurate and reproducible assessment, however optimal CMR thresholds have not been established. We aimed to determine clinically significant thresholds of MR-volume and MR-fraction by CMR in patients with non-ischemic cardiomyopathy (NICM). Methods: All patients having CMR with confirmed NICM between 2001/4/1-2019/3/31 were retrospectively studied. Time to death, heart transplant and/or left ventricular assist device is the primary endpoint, and receiver-operative (ROC) characteristics analyses were used to identify significant cut-points for MR-volume and MR-fraction. Results: Mean MR-volume was 11±12% and MR-fraction 14±13% in 840 NICM patients. C-statistics for the primary endpoint (141 events) were MR-volume 0.629 (95%CI: 0.577-0.691) and MR-fraction 0.594 (95%CI 0.542-0.647). Thresholds of MR-volume≥10mL and MR-fraction≥15% had the highest products of sensitivities and specificities (57.4%, 56.8%; and 54.6%, 63.4% respectively) reflecting elevated risk. MR-volume≥35mL and MR-fraction≥40% were associated the best combination of positive and negative predictive values (40.1%, 84.2%; and 38.4%, 84.6% respectively) representing severe risk. The figure illustrates Kaplan-Meier curves of the primary endpoint, categorized into three subgroups based on aforementioned MR-volume and MR-fraction thresholds. Conclusion: Adverse prognosis are observed when MR-volume≥10mL or MR-fraction≥15%, with increasing risk of adverse outcomes as functional MR severity increased in NICM. The proposed MR thresholds from this study for elevated and severe risk are lower than current valvular regurgitation guidelines, suggesting the need for separate classification schema for functional MR.

Segmentation of cardiac magnetic resonance cine images of single ventricle: including or excluding the accessorial ventricle?

2014 ◽  
Vol 30 (6) ◽  
pp. 1117-1124 ◽  
Author(s):  
Francesco Secchi ◽  
Elda Chiara Resta ◽  
Giovanni Di Leo ◽  
Marcello Petrini ◽  
Carmelo Messina ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Single Ventricle
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