Adults with Fontan circulation: prognostic value of exercise pulmonary vascular resistance index
Authors' conclusion
In adults post-Fontan, PVRI response to exercise is a robust predictor of clinical outcomes and offers additive prognostic information beyond resting invasive haemodynamic data and clinical risk factors
Study context
- Population
- Adults (≥18 years) post-Fontan palliation undergoing exercise (supine cycling) cardiac catheterization
- Participants
- 88 adults
- Exposure
- Absence vs presence of exercise-induced reduction in PVR index (PVRI)
- No PVRI reductionn = 23
- PVRI reductionn = 65reference
- Outcome
- Composite of:
- Death
- Transplantation
- Follow-up
- 2.2 ± 1.4 (IQR 1.2-2.6) years
Main finding
As reported in the abstract
Death or transplantation
Hazard ratio, per WU·m2 (95% CI)P value
Exercise PVRI
2.15(1.24–3.73)
P = 0.007Resting PVRI
0.95(0.52–1.74)
P = 0.86Exercise PVRIadjusted for exercise pulmonary artery wedge pressure
2.08(1.19–3.62)
P = 0.01Per WU·m², as printed
Observational data: associations, not effects.
Further findings
Two-year event-free survival · 2 years
P < 0.001
PVRI at rest and exercise
- Resting PVRI 1.9 ± 0.9 WU·m²
- Exercise PVRI 1.2 (IQR 0.8-2.1) WU·m²
- Clinical, biochemical and echocardiographic parameters not associated with PVRI response to exercise
Original publication
Adults with Fontan circulation: prognostic value of exercise pulmonary vascular resistance index. Eur Heart J. Published 23 December 2025. doi:10.
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