{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:08:12Z","timestamp":1792782492750,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Lovejoy Research and Education Fund"},{"name":"Evan\u2019s Heart Fund"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2026,12]]},"abstract":"Abstract<\/jats:title>\n \n Epicardial and hepatic fat are suspected to play a role in cardiac remodeling. The primary objective of this study was to identify the cardiac MRI (CMR) parameters that are associated with indexed epicardial fat mass (EFM\n \n i<\/jats:italic>\n <\/jats:sub>\n ) and hepatic steatosis in patients after the Fontan operation. This was a single-center, retrospective analysis of Fontan patients. Epicardial and subcutaneous fat were analyzed with CMR post-processing software, cvi42 (Circle Cardiovascular Imaging, Calgary, Alberta, Canada). Hepatic steatosis was measured with controlled attenuation parameter (CAP) scores via vibration controlled transient elastography. The cohort included 82 patients (65% male, median age 16 years). On univariate analysis, EFM\n \n i<\/jats:italic>\n <\/jats:sub>\n correlated with BMI (\u03c1\u2009=\u20090.52,\n p<\/jats:italic>\n \u2009<\u20090.001), age (\u03c1\u2009=\u20090.48,\n p<\/jats:italic>\n \u2009<\u20090.001), ESV\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03c1\u2009=\u20090.44,\n p<\/jats:italic>\n \u2009<\u20090.001), EDV\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03c1\u2009=\u20090.42,\n p<\/jats:italic>\n \u2009<\u20090.001), ventricular mass\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03c1\u2009=\u20090.41,\n p<\/jats:italic>\n \u2009<\u20090.01), subcutaneous fat thickness (\u03c1\u2009=\u20090.32,\n p<\/jats:italic>\n \u2009<\u20090.01), ejection fraction (\u03c1=-0.37,\n p<\/jats:italic>\n \u2009<\u20090.001), and inferior vena cava (IVC) flow\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03c1=-0.26,\n p<\/jats:italic>\n \u2009<\u20090.05). On multivariable regression analysis, BMI (\u03b2 2.21,\n p<\/jats:italic>\n \u2009<\u20090.001) and EDV\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03b2 0.33,\n p<\/jats:italic>\n \u2009<\u20090.001) were independently associated with EFM\n \n i<\/jats:italic>\n <\/jats:sub>\n (R\n 2<\/jats:sup>\n \u2009=\u20090.51). On univariate analysis, CAP scores correlated with BMI (\u03c1\u2009=\u20090.54,\n p<\/jats:italic>\n \u2009<\u20090.001), subcutaneous fat thickness (\u03c1\u2009=\u20090.49,\n p<\/jats:italic>\n \u2009<\u20090.001), subcutaneous fat mass\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03c1\u2009=\u20090.44,\n p<\/jats:italic>\n \u2009<\u20090.001), age (\u03c1\u2009=\u20090.36,\n p<\/jats:italic>\n \u2009<\u20090.01), EFM\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03c1\u2009=\u20090.36,\n p<\/jats:italic>\n \u2009<\u20090.001), and ventricular mass\n \n i<\/jats:italic>\n <\/jats:sub>\n (\u03c1\u2009=\u20090.24,\n p<\/jats:italic>\n \u2009<\u20090.05). On linear regression analysis, BMI (\u03b2 6.6,\n p<\/jats:italic>\n \u2009<\u20090.001) was independently associated with CAP scores (R\n 2<\/jats:sup>\n \u2009=\u20090.27). Neither EFM\n \n i<\/jats:italic>\n <\/jats:sub>\n nor CAP was significantly associated with adverse clinical events. BMI is strongly associated with epicardial and hepatic fat distribution. Epicardial fat mass is also associated with ventricular dilation.\n <\/jats:p>","DOI":"10.1007\/s00246-025-04148-1","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T15:27:40Z","timestamp":1768231660000},"page":"3476-3483","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epicardial Fat is Associated with Ventricular Dilation in Patients After the Fontan Operation"],"prefix":"10.1007","volume":"47","author":[{"given":"Meghan D.","family":"Ryan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole St.","family":"Clair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine K.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul H.","family":"Rathod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"4148_CR1","doi-asserted-by":"publisher","first-page":"e234","DOI":"10.1161\/CIR.0000000000000696","volume":"140","author":"J Rychik","year":"2019","unstructured":"Rychik J, Atz AM, Celermajer DS, Deal BJ, Gatzoulis MA, Gewillig MH, Hsia TY, Hsu DT, Kovacs AH, McCrindle BW, Newburger JW, Pike NA, Rodefeld M, Rosenthal DN, Schumacher KR, Marino BS, Stout K, Veldtman G, Younoszai AK, d\u2019Udekem Y (2019) Evaluation and management of the child and adult with Fontan circulation: A scientific statement from the American Heart Association. 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Dr. Lee has received grant funding from a VCTE manufacturer (Echosens, Paris, France) in the form of machine hardware. No other relevant conflicts.","order":1,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}