{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:15:50Z","timestamp":1784790950709,"version":"3.55.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Exercise cardiac catheterization is the gold standard for diagnosing diastolic dysfunction and impaired pulmonary reserve in patients with Fontan circulation. The diagnostic value of noninvasive parameters is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients who underwent simultaneous exercise hemodynamic evaluation and peripheral venous pressure (PVP) measurement were included. Echocardiographic surrogates for ventricular filling pressure were compared with invasive measures. Diastolic dysfunction was defined invasively as either resting pulmonary artery wedge pressure \u226512\u2009mm\u2009Hg or exercise pulmonary artery wedge pressure &gt;20\u2009mm\u2009Hg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Twenty\u2010nine patients were included. Age at catheterization was 34\u00b19\u2009years. Atrioventricular valve systole\u2010to\u2010diastole duration ratio (S\/D) and resting PVP were significant predictors of resting pulmonary artery wedge pressure (S\/D: \u03b2=0.71 per 0.1 S\/D [95% CI, 0.16\u20131.25];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.01; PVP: \u03b2=0.68 per mm\u2009Hg [95% CI, 0.41\u20130.96];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). By contrast, resting PVP was a predictor of diastolic dysfunction, whereas S\/D was not. Based on these data, we proposed a 2\u2010tier assessment algorithm with the first tier considering resting PVP \u226415\u2009mm\u2009Hg and S\/D \u22641.1 and the second tier considering exercise PVP \u226425\u2009mm\u2009Hg in those with 1 elevated resting parameter. This algorithm showed a positive predictive value of 88% (95% CI, 47%\u2013100%), a negative predictive value of 90% (95% CI, 70%\u201399%), a sensitivity of 78% (95% CI, 40%\u201397%), and a specificity of 95% (95% CI, 75%\u2013100%). Exercise PVP indexed to peak oxygen consumption also predicted invasively measured exercise pulmonary vascular resistance index (\u03b2=0.36 WU\u00b7m\n                      <jats:sup>2<\/jats:sup>\n                      per mm\u2009Hg\/100\u2009mL per min [95% CI, 0.08\u20130.64];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study presents a simple, noninvasive approach for evaluating diastolic function and pulmonary vascular reserve in patients with a Fontan circulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043110","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:02:19Z","timestamp":1762430539000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Noninvasive Evaluation of Ventricular Filling Pressure and Pulmonary Vascular Reserve in Adults With Fontan Circulation"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-8786","authenticated-orcid":false,"given":"Jacob Y.","family":"Cao","sequence":"first","affiliation":[{"name":"Royal Prince Alfred Hospital","place":["Sydney, Australia"]},{"name":"University of Sydney","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1116-8541","authenticated-orcid":false,"given":"C. Charles","family":"Jain","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8810-3631","authenticated-orcid":false,"given":"Alexander C.","family":"Egbe","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5322-0902","authenticated-orcid":false,"given":"Yogesh N. V.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Mayo Clinic","place":["Rochester, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"Starship Children\u2019s\/Auckland City Hospitals","place":["Auckland, New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7349-7554","authenticated-orcid":false,"given":"David","family":"Baker","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital","place":["Sydney, Australia"]},{"name":"University of Sydney","place":["Sydney, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7640-0439","authenticated-orcid":false,"given":"David","family":"Celermajer","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital","place":["Sydney, Australia"]},{"name":"University of Sydney","place":["Sydney, 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