Feasibility, Reproducibility, and Prognostic Value of Exercise Echocardiography for Cardiac Output Reserve Assessment in Fontan Physiology
Authors' conclusion
Patients with Fontan palliation had lower CO reserve, and impaired CO reserve was associated with congestion and cardiovascular events. Further studies are required to determine whether cardiac interventions can improve CO reserve and whether changes in CO reserve can be used as a surrogate end point for therapeutic response.
Study context
- Population
- Adults with Fontan palliation and controls
- Comparison
- Fontan patients vs controls
- Fontann = Thirty-seven
- Controlsn = 61
- Outcome
- Feasibility of CO reserve assessment
Methodological detailssupine cycle ergometer
- Supine cycle ergometer
Main finding
As reported in the abstract
Feasible in Fontan group, with modest reproducibility
95%
Further findings
∆CO/W ratio · lower in Fontan group · similar CO at rest in both groups
P < 0.001
∆CO/∆VO 2 ratio · lower in Fontan group
P = 0.03
Correlation of cardiac output (CO) reserve with log NT-proBNP
- ∆CO/W ratio vs log NT-proBNP
- r=0.65; P <0.001
- ∆CO/∆VO 2 ratio vs log NT-proBNP
- r=0.53; P =0.009
Impaired CO reserve, congestion and cardiovascular events
- Associated with congestion and cardiovascular events; improved prognostication (higher area under the curve and C statistics) above conventional echocardiographic indices and treadmill peak VO 2
Original publication
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