Single ventricular strain measures correlate with peak oxygen consumption in children and adolescents with Fontan circulation.
Document Type
Article
Publication Date
7-2023
Identifier
DOI: 10.1017/S1047951122002323
Abstract
INTRODUCTION: Children with a single ventricle post-Fontan palliation are at increased risk of poor outcomes with peak oxygen consumption acting as a surrogate outcome marker. The purpose of this study is to evaluate the relationship between peak oxygen consumption and echocardiographic measures of ventricular function and deformation, including ventricular global longitudinal strain and dyssynchrony, in children and adolescents following Fontan palliation.
METHODS: Patients (age 8-21 years) with single ventricle post-Fontan palliation were prospectively recruited and participated in an echocardiogram, including views optimised for two-dimensional speckle tracking, and a cardiopulmonary exercise test on a cycle ergometer to maximal volitional fatigue.
RESULTS: Thirty-eight patients (mean age 13.7 ± 2.3 years) post-Fontan palliation had either a single left ventricular (n = 20), single right ventricular (n = 14), or biventricular (n = 4) morphology. Peak oxygen consumption (24.9 ± 5.6 ml/kg/minute) was correlated with global longitudinal strain (r = -0.435, p = 0.007), a strain discoordination time to peak index (r = -0.48, p = 0.003), and the presence of an electro-mechanical dyssynchrony strain pattern (p = 0.008). On multivariate regression modelling, these three variables were associated with peak oxygen consumption independently of age and sex. The single right ventricular group had evidence of possible diastolic dysfunction by E/e' compared to the single left ventricular and biventricular groups (p = 0.001).
CONCLUSIONS: Strain analysis measures are correlated with peak oxygen consumption in this cohort of children, adolescents, and young adults following Fontan palliation, suggesting that ventricular mechanics may influence the efficiency of the Fontan circulation.
Journal Title
Cardiology in the young
Volume
33
Issue
7
First Page
1136
Last Page
1142
MeSH Keywords
Young Adult; Humans; Child; Adolescent; Adult; Fontan Procedure; Heart Ventricles; Echocardiography; Ventricular Function; Oxygen Consumption
Keywords
Fontan; Global longitudinal strain; aerobic capacity; electro-mechanical dyssynchrony; single ventricle
Recommended Citation
Goudar S, Forsha D, White DA, Sherman A, Shirali G. Single ventricular strain measures correlate with peak oxygen consumption in children and adolescents with Fontan circulation. Cardiol Young. 2023;33(7):1136-1142. doi:10.1017/S1047951122002323
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