{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:44:18Z","timestamp":1792662258994,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microcirculation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n Fontan circulation is characterized by chronically elevated central venous pressure (CVP) and reduced cardiac output, which may adversely affect the systemic microcirculation. We investigated whether Fontan circulation is associated with alterations of the endothelial glycocalyx.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Forty\u2010four patients with congenital heart disease undergoing postoperative endothelial glycocalyx evaluation were included. The perfused boundary region (PBR), an inverse indicator of glycocalyx dimensions, was measured noninvasively using GlycoCheck. PBR was compared between patients with Fontan and biventricular circulation, and its relationship with CVP was evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Fourteen patients had Fontan circulation, including three with bidirectional Glenn circulation, and 30 had biventricular circulation. PBR was significantly higher in patients with Fontan circulation than in those with biventricular circulation (2.07\u2009\u00b1\u20090.15 vs. 1.72\u2009\u00b1\u20090.17\u2009\u03bcm,\n p<\/jats:italic>\n \u2009<\u20090.0001). CVP was also significantly higher in the Fontan group (13.0\u2009\u00b1\u20092.2 vs. 7.1\u2009\u00b1\u20092.8\u2009mmHg,\n p<\/jats:italic>\n \u2009<\u20090.0001). PBR was positively correlated with CVP (\n r<\/jats:italic>\n \u2009=\u20090.58,\n p<\/jats:italic>\n \u2009<\u20090.0001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Fontan circulation is associated with an increased PBR, suggesting alterations of the endothelial glycocalyx. The association between PBR and CVP suggests that chronic venous hypertension may be associated with systemic microcirculatory alterations in Fontan circulation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/micc.70092","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:36:01Z","timestamp":1792661761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Microcirculatory Alterations and Endothelial Glycocalyx in Fontan Circulation: Association With Central Venous Pressure"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7815-8658","authenticated-orcid":false,"given":"Masahiro","family":"Shiraishi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Hokkaido University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3961-0434","authenticated-orcid":false,"given":"Gaku","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Graduate School of Medicine Hokkaido University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Graduate School of Medicine Hokkaido University Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1708","volume-title":"Moss and Adams's Heart Disease in Infant, Children, and Adolescents","author":"Edelson J. B.","year":"2022"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"e234","DOI":"10.1161\/CIR.0000000000000696","article-title":"Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association","volume":"140","author":"Rychik J.","year":"2019","journal-title":"Circulation"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1186\/s13054-023-04474-x","article-title":"The Future of Intensive Care: The Study of the Microcirculation Will Help to Guide Our Therapies","volume":"27","author":"Duranteau J.","year":"2023","journal-title":"Critical Care"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s13054-015-0741-z","article-title":"Glycocalyx and Sepsis\u2010Induced Alterations in Vascular Permeability","volume":"19","author":"Chelazzi C.","year":"2015","journal-title":"Critical Care"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.897087","article-title":"The Endothelial Glycocalyx: A Possible Therapeutic Target in Cardiovascular Disorders","volume":"9","author":"Milusev A.","year":"2022","journal-title":"Frontiers in Cardiovascular Medicine"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0096477","article-title":"Deeper Penetration of Erythrocytes Into the Endothelial Glycocalyx Is Associated With Impaired Microvascular Perfusion","volume":"9","author":"Lee D. H.","year":"2014","journal-title":"PLoS One"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0243737","article-title":"Assessment of the Sublingual Microcirculation With the GlycoCheck System: Reproducibility and Examination Conditions","volume":"15","author":"Eickhoff M. K.","year":"2020","journal-title":"PLoS One"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"3133","DOI":"10.1038\/s41598-021-81847-8","article-title":"Effect of Gestational Age and Postnatal Age on the Endothelial Glycocalyx in Neonates","volume":"11","author":"Puchwein\u2010Schwepcke A.","year":"2021","journal-title":"Scientific Reports"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.amjcard.2021.06.022","article-title":"Impact of Protein\u2010Losing Enteropathy on Inflammatory Biomarkers and Vascular Dysfunction in Fontan Circulation","volume":"155","author":"Rychik J.","year":"2021","journal-title":"American Journal of Cardiology"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1007\/s12265-021-10180-2","article-title":"Impaired Endothelial Glycocalyx Predicts Adverse Outcome in Subjects Without Overt Cardiovascular Disease: A 6\u2010Year Follow\u2010Up Study","volume":"15","author":"Ikonomidis I.","year":"2022","journal-title":"Journal of Cardiovascular Translational Research"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1177\/0310057X20916471","article-title":"Decreased Endothelial Glycocalyx Thickness Is an Early Predictor of Mortality in Sepsis","volume":"48","author":"Beurskens D. M.","year":"2020","journal-title":"Anaesthesia and Intensive Care"},{"key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"e117","DOI":"10.1016\/j.jacc.2023.12.035","article-title":"Aging in Patients With Fontan Circulation: Raison D'\u00eatre of Right Ventricle","volume":"83","author":"Murakami T.","year":"2024","journal-title":"Journal of the American College of Cardiology"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/bja\/aew187","article-title":"Microcirculatory Changes in Children Undergoing Cardiac Surgery: A Prospective Observational Study","volume":"117","author":"Scolletta S.","year":"2016","journal-title":"British Journal of Anaesthesia"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm15020839","article-title":"Glycocalyx Degradation in Pediatric Patients With Cyanotic and Acyanotic Congenital Heart Disease Undergoing Cardiac Repair Surgery","volume":"15","author":"Sciefer J.","year":"2026","journal-title":"Journal of Clinical Medicine"}],"container-title":["Microcirculation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/micc.70092","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/micc.70092","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/micc.70092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:36:04Z","timestamp":1792661764000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/micc.70092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/micc.70092"],"URL":"https:\/\/doi.org\/10.1111\/micc.70092","archive":["Portico"],"relation":{},"ISSN":["1073-9688","1549-8719"],"issn-type":[{"value":"1073-9688","type":"print"},{"value":"1549-8719","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70092"}}