{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:30:48Z","timestamp":1792042248148,"version":"4.4.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>The Fontan procedure has revolutionized the treatment of univentricular hearts. However, it is associated with severe complications such as protein-losing enteropathy, plastic bronchitis, and peripheral edema that may involve the lymphatic circulation. We aimed to assess lymphatic function and morphology in patients with a univentricular circulation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The functional state of lymphatic vessels in the lower extremities of patients with a Fontan circulation (n=10) was investigated using the novel technique near-infrared fluorescence imaging and compared with an age-, sex-, and weight-matched control group of healthy volunteers (n=10). The lymphatic morphology was described using T2-weighted magnetic resonance imaging, and microvascular permeability was estimated by strain gauge plethysmography.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The Fontan patients had 17% lower lymphatic pumping pressure (50\u00b13.1 mm\u2009Hg) compared with controls (60\u00b12.8 mm\u2009Hg;\n              <jats:italic>P<\/jats:italic>\n              =0.0341) and a 62% higher contraction frequency (0.8\u00b10.1 min\n              <jats:sup>\u22121<\/jats:sup>\n              ) compared with the healthy controls (0.5\u00b10.1 min\n              <jats:sup>\u22121<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.0432). Velocity by which the lymph is moved and refill time after manual emptying of the lymphatic vessels showed no differences between the 2 groups. The thoracic duct was elongated 10% (\n              <jats:italic>P<\/jats:italic>\n              =0.0409) and with an abnormal course in the Fontan patients compared with normal. No difference in microvascular permeability was found between the 2 groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Patients with a Fontan circulation have an impaired lymphatic pumping capacity and morphologically changed thoracic duct. Our results indicate a challenged lymphatic vasculature in the Fontan circulation and may play a role in the pathogenesis of the complications that are seen in Fontan patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT03379805.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.118.008074","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T09:02:09Z","timestamp":1554368529000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":73,"title":["Morphology and Function of the Lymphatic Vasculature in Patients With a Fontan Circulation"],"prefix":"10.1161","volume":"12","author":[{"given":"Sheyanth","family":"Mohanakumar","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark (S.M., N.T., B.K., V.H.)."},{"name":"Department of Clinical Medicine (S.M., N.T., B.K., D.B., M.P., V.H.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas","family":"Telinius","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark (S.M., N.T., B.K., V.H.)."},{"name":"Department of Clinical Medicine (S.M., N.T., B.K., D.B., M.P., V.H.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark (S.M., N.T., B.K., V.H.)."},{"name":"Department of Clinical Medicine (S.M., N.T., B.K., D.B., M.P., V.H.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Lauridsen","sequence":"additional","affiliation":[{"name":"Comparative Medicine Lab, Department of Clinical Medicine (H.L., M.P.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Boedtkjer","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine (S.M., N.T., B.K., D.B., M.P., V.H.), Aarhus University, Denmark."},{"name":"Department of Biomedicine (D.B.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine (S.M., N.T., B.K., D.B., M.P., V.H.), Aarhus University, Denmark."},{"name":"Comparative Medicine Lab, Department of Clinical Medicine (H.L., M.P.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"de Leval","sequence":"additional","affiliation":[{"name":"The Harley Street Clinic Children\u2019s Hospital, London, United Kingdom (M.d.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibeke","family":"Hjortdal","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark (S.M., N.T., B.K., V.H.)."},{"name":"Department of Clinical Medicine (S.M., N.T., B.K., D.B., M.P., V.H.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.03.004"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.12.054"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2008.00201.x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2007.00116.x"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2010.99"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951111000102"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.559"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.11797"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.6.2136"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.tvir.2016.10.007"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3723"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.021"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0061"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2014.276683"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2002.018291"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1993.sp019642"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000070951.93566.FC"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.5.6.844"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.1997.v26.pm0009303499"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.86.2.420"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.3.001256"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2016.0039"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01089.2009"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1159\/000342437"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01098.2011"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2014.0015"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2015.0045"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01097.2011"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1006\/mvre.1995.1008"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2007.130401"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.05.096"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/10739680490476033"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e31823931f5"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14131399"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019710"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.023"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.1986.250.5.H706"}],"container-title":["Circulation: Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCIMAGING.118.008074","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:44:55Z","timestamp":1715568295000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCIMAGING.118.008074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1161\/CIRCIMAGING.118.008074"],"URL":"https:\/\/doi.org\/10.1161\/circimaging.118.008074","relation":{},"ISSN":["1941-9651","1942-0080"],"issn-type":[{"value":"1941-9651","type":"print"},{"value":"1942-0080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]},"assertion":[{"value":"2018-06-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e008074"}}