{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:07:39Z","timestamp":1787728059303,"version":"build-2784847793"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T00:00:00Z","timestamp":1666483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T00:00:00Z","timestamp":1666483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23 HL141448"],"award-info":[{"award-number":["K23 HL141448"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 HL158517"],"award-info":[{"award-number":["R01 HL158517"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 160761"],"award-info":[{"award-number":["R01 160761"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23 HL141448"],"award-info":[{"award-number":["K23 HL141448"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 HL158517"],"award-info":[{"award-number":["R01 HL158517"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 160761"],"award-info":[{"award-number":["R01 160761"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Despite their universal predisposition, diagnosing diastolic dysfunction in patients post-Fontan palliation is challenging. Our aim was to compare exercise haemodynamics between adults post-Fontan and patients with heart failure with preserved ejection fraction (HFpEF) and non-cardiac dyspnoea (NCD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Twenty-four adults (age \u226518\u2009years) post-Fontan palliation with resting and exercise pulmonary artery wedge pressure (PAWP) measured during supine biking were identified. Forty-eight patients with HFpEF and 48 with NCD diagnosed at catheterization were selected for comparison. Mean age for Fontan patients was 30.3\u2009\u00b1\u20097.5\u2009years; median ventricular ejection fraction was 52.5% (45\u201355.8), being &amp;lt;50% in 37.5%. Resting PAWP among Fontan patients was 10.2\u2009\u00b1\u20093.5\u2009mmHg (&amp;gt;12\u2009mmHg in 25%); PAWP was lower in Fontan patients than in HFpEF but higher than NCD. During exercise, PAWP was lower in the Fontan group than HFpEF (22.5\u2009mmHg [19.3\u201328] vs. 28.2\u2009\u00b1\u20096.3; p = 0.0006) but higher than NCD (11.2\u2009\u00b1\u20094.2, p\u2009\u2264\u20090.0001). However, there were no differences in \u0394PAWP\/\u0394Qs between Fontan and HFpEF patients (4.0 [2.1\u20137.3] vs. 2.7 [1.6\u20134.4]; p = 0.10) with the ratio being higher post-Fontan than in NCD (0.6 [0.2\u20131.2]; p\u2009&amp;lt;\u20090.0001). \u0394PAWP\/\u0394Qs remained similar between HFpEF and Fontan patients even when those with ejection fraction &amp;lt;50% were excluded (2.7 [1.6\u20134.4] vs. 2.7 [1.0\u20135.8]; p = 0.97).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There were no differences in \u0394PAWP\/\u0394Qs ratios between post-Fontan and HFpEF patients, supporting markedly abnormal single ventricle compliance despite lower resting and exercise PAWP. Therefore, exercise invasive haemodynamics may represent a novel tool for the diagnosis of diastolic dysfunction in Fontan patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2706","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T14:00:52Z","timestamp":1664892052000},"page":"17-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Exercise-Induced Changes in Pulmonary Artery Wedge Pressure in Adults Post-Fontan Versus Heart Failure with Preserved Ejection Fraction and Non-Cardiac Dyspnoea"],"prefix":"10.1093","volume":"25","author":[{"given":"William R.","family":"Miranda","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry A.","family":"Borlaug","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Charles","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason H.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald J.","family":"Hagler","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]},{"name":"Division of Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi M.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander C.","family":"Egbe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,23]]},"reference":[{"key":"2026010913081747200_ejhf2706-bib-0001","first-page":"559","volume-title":"Paediatric cardiology","author":"Choussat","year":"1978"},{"key":"2026010913081747200_ejhf2706-bib-0002","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1161\/01.CIR.82.5.1681","article-title":"Baffle fenestration with subsequent transcatheter closure. 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