{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:14:04Z","timestamp":1763018044541,"version":"3.40.5"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"},{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951119000258_as1\"><jats:title>Background:<\/jats:title><jats:p>Late Fontan survivors are at high risk to experience heart failure and death. Therefore, the current study sought to investigate the role of non-invasive diagnostics as prognostic markers for failure of the systemic ventricle following Fontan procedure.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951119000258_as2\"><jats:title>Methods:<\/jats:title><jats:p>This monocentric, longitudinal observational study included 60 patients with a median age of 24.5 (19\u201329) years, who were subjected to cardiac magnetic resonance imaging, echocardiography, cardiopulmonary exercise testing, and blood analysis. The primary endpoint of this study was decompensated heart failure with symptoms at rest, peripheral and\/or pulmonary edema, and\/or death.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951119000258_as3\"><jats:title>Results:<\/jats:title><jats:p>During a follow-up of 24 months, 5 patients died and 5 patients suffered from decompensated heart failure. Clinical (NYHA class, initial surgery), functional (VO<jats:sub>2<\/jats:sub>peak, ejection fraction, cardiac index), circulating biomarkers (N-terminal pro brain natriuretic peptide), and imaging parameters (end diastolic volume index, end systolic volume index, mass-index, contractility, afterload) were significantly related to the primary endpoint. Multi-variate regression analysis identified afterload as assessed by cardiac magnetic resonance imaging as an independent predictor of the primary endpoint (hazard ratio 1.98, 95% confidence interval 1.19\u20133.29, p = 0.009).<\/jats:p><\/jats:sec><jats:sec id=\"S1047951119000258_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>We identified distinct parameters of cardiopulmonary exercise testing, cardiac magnetic resonance imaging, and blood testing as markers for future decompensated heart failure and death in patients with Fontan circulation. Importantly, our data also identify increased afterload as an independent predictor for increased morbidity and mortality. This parameter is easy to assess by non-invasive cardiac magnetic resonance imaging. Its modulation may represent a potential therapeutic approach target in these high-risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951119000258","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T20:17:37Z","timestamp":1556655457000},"page":"602-609","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Prediction of heart failure and death in an adult population of Fontan patients"],"prefix":"10.1017","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3215-7734","authenticated-orcid":false,"given":"Jan Thorben","family":"Sieweke","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arash","family":"Haghikia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Riehle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolin","family":"Klages","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muharrem","family":"Akin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolin","family":"Zwadlo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Treptau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johann","family":"Bauersachs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mechthild","family":"Westhoff-Bleck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2019,4,30]]},"reference":[{"doi-asserted-by":"publisher","key":"S1047951119000258_ref21","DOI":"10.1016\/j.jacc.2008.10.001"},{"key":"S1047951119000258_ref12","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1161\/01.CIR.0000073597.57414.A9","article-title":"ACC\/AHA\/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines (ACC\/AHA\/ASE committee to update the 1997 guidelines for the clinical application of echocardiography)","volume":"108","author":"Cheitlin","year":"2003","journal-title":"Circulation"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref10","DOI":"10.1016\/j.amjcard.2008.01.050"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref4","DOI":"10.1161\/CIRCULATIONAHA.107.738559"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref30","DOI":"10.1093\/eurjhf\/hft063"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref24","DOI":"10.1161\/01.CIR.81.6.2016"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref22","DOI":"10.1016\/j.athoracsur.2007.11.009"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref18","DOI":"10.1161\/01.CIR.103.17.2176"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref8","DOI":"10.1161\/CIRCIMAGING.111.966986"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref28","DOI":"10.1016\/j.cjca.2015.11.013"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref14","DOI":"10.1093\/eurheartj\/ehq356"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref26","DOI":"10.1016\/j.jtcvs.2013.12.046"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref19","DOI":"10.1017\/S1047951105001642"},{"key":"S1047951119000258_ref1","first-page":"39","article-title":"\u201cCorrection\u201d of tricuspid atresia. 2 cases \u201ccorrected\u201d using a new surgical technic","volume":"10","author":"Fontan","year":"1971","journal-title":"Ann Chir Thorac Cardiovasc"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref7","DOI":"10.1161\/CIRCULATIONAHA.104.529800"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref5","DOI":"10.1111\/chd.12401"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref20","DOI":"10.1161\/CIRCIMAGING.113.001473"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref27","DOI":"10.1016\/j.ijcard.2017.02.140"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref29","DOI":"10.1016\/j.amjcard.2004.10.014"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref23","DOI":"10.1161\/CIRCULATIONAHA.105.594218"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref16","DOI":"10.1016\/j.ijcard.2012.04.015"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref11","DOI":"10.1016\/j.ijcard.2015.05.181"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref6","DOI":"10.1136\/heartjnl-2015-307514"},{"key":"S1047951119000258_ref2","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/S0022-5223(19)35174-8","article-title":"Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex fontan operations. experimental studies and early clinical experience","volume":"96","author":"de Leval","year":"1988","journal-title":"J Thorac Cardiovasc Surg"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref9","DOI":"10.1002\/ejhf.592"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref3","DOI":"10.1161\/CIRCULATIONAHA.115.017202"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref15","DOI":"10.1016\/j.jjcc.2016.04.001"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref17","DOI":"10.1016\/j.ijcard.2014.03.001"},{"key":"S1047951119000258_ref13","first-page":"1","article-title":"Aerobic work capacity in men and women with special reference to age","volume":"49","year":"1960","journal-title":"Acta Physiol Scand Suppl"},{"doi-asserted-by":"publisher","key":"S1047951119000258_ref25","DOI":"10.1016\/S1010-7940(97)00220-0"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951119000258","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T09:38:04Z","timestamp":1607506684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951119000258\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,30]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["S1047951119000258"],"URL":"https:\/\/doi.org\/10.1017\/s1047951119000258","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"type":"print","value":"1047-9511"},{"type":"electronic","value":"1467-1107"}],"subject":[],"published":{"date-parts":[[2019,4,30]]},"assertion":[{"value":"\u00a9 Cambridge University Press 2019\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}