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Role of Doppler echocardiography for cardiac output assessment in Fontan patients
To determine (1) correlation between Doppler stroke volume index (SVI) and cardiac magnetic resonance imaging (CMRI) SVI and (2) association between Doppler SVI and Fontan-associated diseases (FAD) and Fontan failure. Review of Fontan patients who underwent same-day CMRI and transthoracic echocardio...
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| Published in: | The American heart journal 2018-01, Vol.195, p.91-98 |
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| container_title | The American heart journal |
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| creator | Egbe, Alexander Khan, Arooj R. Khan, Sana F. Anavekar, Nandan S. Said, Sameh M. Young, Philip M. Akintoye, Emmanuel Miranda, William R. Al-Otaibi, Mohamad N. Veldtman, Gruschen R. Connolly, Heidi M. |
| description | To determine (1) correlation between Doppler stroke volume index (SVI) and cardiac magnetic resonance imaging (CMRI) SVI and (2) association between Doppler SVI and Fontan-associated diseases (FAD) and Fontan failure.
Review of Fontan patients who underwent same-day CMRI and transthoracic echocardiography (TTE), 2005 to 2015. We defined FAD as cardiac thrombus, protein-losing enteropathy, arrhythmia, and hospitalization for heart failure. Fontan failure was defined as Fontan conversion or revision, heart transplantation or listing, or death.
Fifty-three patients with systemic left ventricle (LV) underwent 86 sets of TTE/CMRI. Mean (SD) age 31 (6) years. SVI (45 [16] vs 42 [13] mL/m2), CI (3.0 [1.1] vs 2.8 [0.8] L min−1 m−2), and ejection fraction (53 [4]% vs 51 [5]%) were similar for both modalities (P>.05 for all). Doppler SVI correlated with CMRI (r=0.68; P |
| doi_str_mv | 10.1016/j.ahj.2017.09.014 |
| format | article |
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Review of Fontan patients who underwent same-day CMRI and transthoracic echocardiography (TTE), 2005 to 2015. We defined FAD as cardiac thrombus, protein-losing enteropathy, arrhythmia, and hospitalization for heart failure. Fontan failure was defined as Fontan conversion or revision, heart transplantation or listing, or death.
Fifty-three patients with systemic left ventricle (LV) underwent 86 sets of TTE/CMRI. Mean (SD) age 31 (6) years. SVI (45 [16] vs 42 [13] mL/m2), CI (3.0 [1.1] vs 2.8 [0.8] L min−1 m−2), and ejection fraction (53 [4]% vs 51 [5]%) were similar for both modalities (P>.05 for all). Doppler SVI correlated with CMRI (r=0.68; P<.001). Sixteen patients had cirrhosis, and these patients had a higher CI (3.9 [0.9] vs 2.8 [1.0] L min−1 m−2; P<.01). Among the 37 patients without cirrhosis, Doppler SVI <39 mL/m2 was associated with FAD (odds ratio [OR], 2.11; 95% confidence limit, 1.26–3.14; P=.02); Fontan failure was more common in patients with CI was <2.5 L min−1 m−2 (3/9 [33%] vs 0/28 [0%], P=.01).
Another 11 patients with systemic right ventricle (RV) underwent 17 sets of TTE/CMRI, mean (SD) age 17 (3) years, and CMRI SVI also correlated with Doppler SVI (r=0.75; P<.001).
Doppler SVI correlated with CMRI SVI in patients with systemic LV and systemic RV. The association between output measures (SVI and CI) and FAD were seen only in single LV patients (single RV patients not assessed for this outcome due to small numbers). An association between low Doppler CI and Fontan failure was suggested in a small number of single LV patients.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2017.09.014</identifier><identifier>PMID: 29224651</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Anesthesia ; Arrhythmia ; Cardiac output ; Cirrhosis ; Confidence intervals ; Confidence limits ; Correlation ; Doppler effect ; Echocardiography ; Echocardiography, Doppler - methods ; Electrocardiography ; Female ; Flow velocity ; Fontan Procedure ; Heart ; Heart Defects, Congenital - diagnosis ; Heart Defects, Congenital - physiopathology ; Heart diseases ; Heart surgery ; Heart transplantation ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Heart Ventricles - surgery ; Humans ; Intubation ; Liver cirrhosis ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Cine ; Male ; Morphology ; NMR ; Nuclear magnetic resonance ; Patients ; Pediatrics ; Physiology ; Reproducibility of Results ; Retrospective Studies ; Stroke ; Stroke volume ; Stroke Volume - physiology ; Thrombosis ; Transplantation ; Transplants & implants ; Ventricle</subject><ispartof>The American heart journal, 2018-01, Vol.195, p.91-98</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>2017. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c381t-95422162bbd3bdddb6acbcd54d5b10af30fa533b9b3570552403186931769bd83</citedby><cites>FETCH-LOGICAL-c381t-95422162bbd3bdddb6acbcd54d5b10af30fa533b9b3570552403186931769bd83</cites><orcidid>0000-0002-8810-3631</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29224651$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egbe, Alexander</creatorcontrib><creatorcontrib>Khan, Arooj R.</creatorcontrib><creatorcontrib>Khan, Sana F.</creatorcontrib><creatorcontrib>Anavekar, Nandan S.</creatorcontrib><creatorcontrib>Said, Sameh M.</creatorcontrib><creatorcontrib>Young, Philip M.</creatorcontrib><creatorcontrib>Akintoye, Emmanuel</creatorcontrib><creatorcontrib>Miranda, William R.</creatorcontrib><creatorcontrib>Al-Otaibi, Mohamad N.</creatorcontrib><creatorcontrib>Veldtman, Gruschen R.</creatorcontrib><creatorcontrib>Connolly, Heidi M.</creatorcontrib><title>Role of Doppler echocardiography for cardiac output assessment in Fontan patients</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>To determine (1) correlation between Doppler stroke volume index (SVI) and cardiac magnetic resonance imaging (CMRI) SVI and (2) association between Doppler SVI and Fontan-associated diseases (FAD) and Fontan failure.
Review of Fontan patients who underwent same-day CMRI and transthoracic echocardiography (TTE), 2005 to 2015. We defined FAD as cardiac thrombus, protein-losing enteropathy, arrhythmia, and hospitalization for heart failure. Fontan failure was defined as Fontan conversion or revision, heart transplantation or listing, or death.
Fifty-three patients with systemic left ventricle (LV) underwent 86 sets of TTE/CMRI. Mean (SD) age 31 (6) years. SVI (45 [16] vs 42 [13] mL/m2), CI (3.0 [1.1] vs 2.8 [0.8] L min−1 m−2), and ejection fraction (53 [4]% vs 51 [5]%) were similar for both modalities (P>.05 for all). Doppler SVI correlated with CMRI (r=0.68; P<.001). Sixteen patients had cirrhosis, and these patients had a higher CI (3.9 [0.9] vs 2.8 [1.0] L min−1 m−2; P<.01). Among the 37 patients without cirrhosis, Doppler SVI <39 mL/m2 was associated with FAD (odds ratio [OR], 2.11; 95% confidence limit, 1.26–3.14; P=.02); Fontan failure was more common in patients with CI was <2.5 L min−1 m−2 (3/9 [33%] vs 0/28 [0%], P=.01).
Another 11 patients with systemic right ventricle (RV) underwent 17 sets of TTE/CMRI, mean (SD) age 17 (3) years, and CMRI SVI also correlated with Doppler SVI (r=0.75; P<.001).
Doppler SVI correlated with CMRI SVI in patients with systemic LV and systemic RV. The association between output measures (SVI and CI) and FAD were seen only in single LV patients (single RV patients not assessed for this outcome due to small numbers). An association between low Doppler CI and Fontan failure was suggested in a small number of single LV patients.</description><subject>Adult</subject><subject>Anesthesia</subject><subject>Arrhythmia</subject><subject>Cardiac output</subject><subject>Cirrhosis</subject><subject>Confidence intervals</subject><subject>Confidence limits</subject><subject>Correlation</subject><subject>Doppler effect</subject><subject>Echocardiography</subject><subject>Echocardiography, Doppler - methods</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Fontan Procedure</subject><subject>Heart</subject><subject>Heart Defects, Congenital - diagnosis</subject><subject>Heart Defects, Congenital - physiopathology</subject><subject>Heart diseases</subject><subject>Heart surgery</subject><subject>Heart transplantation</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Heart Ventricles - surgery</subject><subject>Humans</subject><subject>Intubation</subject><subject>Liver cirrhosis</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Male</subject><subject>Morphology</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Physiology</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Stroke</subject><subject>Stroke volume</subject><subject>Stroke Volume - physiology</subject><subject>Thrombosis</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Ventricle</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kMtKxDAUhoMozjj6AG4k4MZNay5N2uBKvIMgiq5DbnVaOk1NWsG3N-OoCxeuDufw_T-HD4BDjHKMMD9tc7Vsc4JwmSORI1xsgTlGosx4WRTbYI4QIllVIjoDezG2aeWk4rtgRgQhBWd4Dh6ffOegr-GlH4bOBejM0hsVbONfgxqWH7D2AX4dlIF-GodphCpGF-PK9SNsenjt-1H1cFBjky5xH-zUqovu4HsuwMv11fPFbXb_cHN3cX6fGVrhMROsIARzorWl2lqruTLaWFZYpjFSNUW1YpRqoSkrEWOkQBRXXFBccqFtRRfgZNM7BP82uTjKVRON6zrVOz9FiUXJmGBEFAk9_oO2fgp9-m5NlQyncp4ovKFM8DEGV8shNCsVPiRGcu1btjL5lmvfEgmZfKfM0XfzpFfO_iZ-BCfgbAO4pOK9cUFGkzQZZ5vgzCitb_6p_wT7Zo-M</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Egbe, Alexander</creator><creator>Khan, Arooj R.</creator><creator>Khan, Sana F.</creator><creator>Anavekar, Nandan S.</creator><creator>Said, Sameh M.</creator><creator>Young, Philip M.</creator><creator>Akintoye, Emmanuel</creator><creator>Miranda, William R.</creator><creator>Al-Otaibi, Mohamad N.</creator><creator>Veldtman, Gruschen R.</creator><creator>Connolly, Heidi M.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8810-3631</orcidid></search><sort><creationdate>201801</creationdate><title>Role of Doppler echocardiography for cardiac output assessment in Fontan patients</title><author>Egbe, Alexander ; Khan, Arooj R. ; Khan, Sana F. ; Anavekar, Nandan S. ; Said, Sameh M. ; Young, Philip M. ; Akintoye, Emmanuel ; Miranda, William R. ; Al-Otaibi, Mohamad N. ; Veldtman, Gruschen R. ; Connolly, Heidi M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c381t-95422162bbd3bdddb6acbcd54d5b10af30fa533b9b3570552403186931769bd83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Anesthesia</topic><topic>Arrhythmia</topic><topic>Cardiac output</topic><topic>Cirrhosis</topic><topic>Confidence intervals</topic><topic>Confidence limits</topic><topic>Correlation</topic><topic>Doppler effect</topic><topic>Echocardiography</topic><topic>Echocardiography, Doppler - methods</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Fontan Procedure</topic><topic>Heart</topic><topic>Heart Defects, Congenital - diagnosis</topic><topic>Heart Defects, Congenital - physiopathology</topic><topic>Heart diseases</topic><topic>Heart surgery</topic><topic>Heart transplantation</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Heart Ventricles - surgery</topic><topic>Humans</topic><topic>Intubation</topic><topic>Liver cirrhosis</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging, Cine</topic><topic>Male</topic><topic>Morphology</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Physiology</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Stroke</topic><topic>Stroke volume</topic><topic>Stroke Volume - physiology</topic><topic>Thrombosis</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egbe, Alexander</creatorcontrib><creatorcontrib>Khan, Arooj R.</creatorcontrib><creatorcontrib>Khan, Sana F.</creatorcontrib><creatorcontrib>Anavekar, Nandan S.</creatorcontrib><creatorcontrib>Said, Sameh M.</creatorcontrib><creatorcontrib>Young, Philip M.</creatorcontrib><creatorcontrib>Akintoye, Emmanuel</creatorcontrib><creatorcontrib>Miranda, William R.</creatorcontrib><creatorcontrib>Al-Otaibi, Mohamad N.</creatorcontrib><creatorcontrib>Veldtman, Gruschen R.</creatorcontrib><creatorcontrib>Connolly, Heidi M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Healthcare Administration Database</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egbe, Alexander</au><au>Khan, Arooj R.</au><au>Khan, Sana F.</au><au>Anavekar, Nandan S.</au><au>Said, Sameh M.</au><au>Young, Philip M.</au><au>Akintoye, Emmanuel</au><au>Miranda, William R.</au><au>Al-Otaibi, Mohamad N.</au><au>Veldtman, Gruschen R.</au><au>Connolly, Heidi M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of Doppler echocardiography for cardiac output assessment in Fontan patients</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2018-01</date><risdate>2018</risdate><volume>195</volume><spage>91</spage><epage>98</epage><pages>91-98</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><abstract>To determine (1) correlation between Doppler stroke volume index (SVI) and cardiac magnetic resonance imaging (CMRI) SVI and (2) association between Doppler SVI and Fontan-associated diseases (FAD) and Fontan failure.
Review of Fontan patients who underwent same-day CMRI and transthoracic echocardiography (TTE), 2005 to 2015. We defined FAD as cardiac thrombus, protein-losing enteropathy, arrhythmia, and hospitalization for heart failure. Fontan failure was defined as Fontan conversion or revision, heart transplantation or listing, or death.
Fifty-three patients with systemic left ventricle (LV) underwent 86 sets of TTE/CMRI. Mean (SD) age 31 (6) years. SVI (45 [16] vs 42 [13] mL/m2), CI (3.0 [1.1] vs 2.8 [0.8] L min−1 m−2), and ejection fraction (53 [4]% vs 51 [5]%) were similar for both modalities (P>.05 for all). Doppler SVI correlated with CMRI (r=0.68; P<.001). Sixteen patients had cirrhosis, and these patients had a higher CI (3.9 [0.9] vs 2.8 [1.0] L min−1 m−2; P<.01). Among the 37 patients without cirrhosis, Doppler SVI <39 mL/m2 was associated with FAD (odds ratio [OR], 2.11; 95% confidence limit, 1.26–3.14; P=.02); Fontan failure was more common in patients with CI was <2.5 L min−1 m−2 (3/9 [33%] vs 0/28 [0%], P=.01).
Another 11 patients with systemic right ventricle (RV) underwent 17 sets of TTE/CMRI, mean (SD) age 17 (3) years, and CMRI SVI also correlated with Doppler SVI (r=0.75; P<.001).
Doppler SVI correlated with CMRI SVI in patients with systemic LV and systemic RV. The association between output measures (SVI and CI) and FAD were seen only in single LV patients (single RV patients not assessed for this outcome due to small numbers). An association between low Doppler CI and Fontan failure was suggested in a small number of single LV patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29224651</pmid><doi>10.1016/j.ahj.2017.09.014</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8810-3631</orcidid></addata></record> |
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| ispartof | The American heart journal, 2018-01, Vol.195, p.91-98 |
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| source | ScienceDirect Freedom Collection |
| subjects | Adult Anesthesia Arrhythmia Cardiac output Cirrhosis Confidence intervals Confidence limits Correlation Doppler effect Echocardiography Echocardiography, Doppler - methods Electrocardiography Female Flow velocity Fontan Procedure Heart Heart Defects, Congenital - diagnosis Heart Defects, Congenital - physiopathology Heart diseases Heart surgery Heart transplantation Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Heart Ventricles - surgery Humans Intubation Liver cirrhosis Magnetic resonance imaging Magnetic Resonance Imaging, Cine Male Morphology NMR Nuclear magnetic resonance Patients Pediatrics Physiology Reproducibility of Results Retrospective Studies Stroke Stroke volume Stroke Volume - physiology Thrombosis Transplantation Transplants & implants Ventricle |
| title | Role of Doppler echocardiography for cardiac output assessment in Fontan patients |
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