{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T15:47:38Z","timestamp":1776440858115,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fontan patients may have abnormal diastolic function, but this is poorly characterized using conventional echocardiography. Herein, we describe atrial function and other diastolic strain measurements in a cohort of pediatric Fontan patients, with comparisons to healthy controls and between right ventricle (RV) and left ventricle (LV) types.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010institution, cross\u2010sectional study of healthy controls (<jats:italic>n<\/jats:italic> = 50) and patients with a Fontan circulation (<jats:italic>n<\/jats:italic> = 50, 29 RV type, 21 LV type). Parameters of atrial function and ventricular systolic and diastolic function derived from speckle\u2010tracking echocardiography (STE) were retrospectively obtained from apical four\u2010chamber images. These included three phases of atrial strain (\u0190) and strain rate (SR): contraction (ac), conduit (con), and reservoir (res), and diastolic SR for passive (E\u2010SR) and active (A\u2010SR) filling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fontan patients had lower \u0190con (13.4%\u00a0vs. 28.2%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and \u0190res (22.8%\u00a0vs. 37.7%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) compared to controls. They had a longer time to peak atrial filling (450 ms vs. 399 ms, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and a greater reliance on atrial contraction for ventricular filling (atrial contraction fraction 41%\u00a0vs. 26%, <jats:italic>p<\/jats:italic> &lt;\u00a00.01). RV type Fontan patients had longer time to peak atrial filling (461 ms vs. 406 ms, <jats:italic>p<\/jats:italic> = 0.02) and lower E\u2010SR (1.0 %\/s vs. 1.4%\/s, <jats:italic>p<\/jats:italic> = 0.01) compared to LV type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Several atrial and diastolic strain parameters in pediatric Fontan patients are altered compared to controls. Additionally, some metrics are more deranged in RV type Fontan patients. This highlights the need for population\u2010specific normal values in patients with a Fontan circulation. Study of the clinical correlations and prognostic value of these STE\u2010derived parameters is also warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.70133","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T05:25:44Z","timestamp":1745645144000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Strain Measures of Atrial and Ventricular Diastolic Function in Pediatric Fontan Patients: Comparisons to Controls and Between Ventricular Morphology Types"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3859-1294","authenticated-orcid":false,"given":"Robert W.","family":"Loar","sequence":"first","affiliation":[{"name":"Pediatric Cardiology Cook Children's Medical Center  Fort Worth Texas USA"},{"name":"Department of Pediatrics Burnett School Medicine at TCU  Fort Worth Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo H.","family":"Pignatelli","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Department of Pediatrics Baylor College of Medicine\/Texas Children's Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Christopher","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Department of Pediatrics Baylor College of Medicine\/Texas Children's Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher R.","family":"Broda","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Department of Pediatrics Baylor College of Medicine\/Texas Children's Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John L.","family":"Colquitt","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Department of Pediatrics University of Utah  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2013.09.010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.26.3.240"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.065"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000346"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.01.011"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-015-9520-9"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02351-w"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-021-02329-6"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02484-y"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-021-02298-w"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jew015"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht179"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2021.07.013"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.01.015"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.04.005"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey042"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.12834"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2019.11.004"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2020.02.015"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.01.027"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-007-0495-y"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12814"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02435-7"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70133","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T09:34:11Z","timestamp":1754904851000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.70133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,26]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/echo.70133"],"URL":"https:\/\/doi.org\/10.1111\/echo.70133","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,26]]},"assertion":[{"value":"2024-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70133"}}