Increased Endothelin-1 Is Associated With Morbidity in Single Ventricle Heart Disease in Children Undergoing Fontan Palliation
Authors' conclusion
SVHD children with higher peri-operative ET1 experience more post-stage 3 morbidity. Failure to suppress ET1 may be a modifiable risk factor for intolerance of SVHD palliation.
Study context
- Population
- Children with single ventricle heart disease (SVHD) undergoing stage 3 (Fontan) palliation, and controlschildren with SVHD undergoing stage 3 palliation 84 · controls 50
- Participants
- 84 vs 50
- Exposure
- Persistent failure to suppress ET1 and impaired recovery among children with SVHD undergoing the stage 3 (Fontan) operation
- SVHD casesn = 84
- Controlsn = 50
- Outcome
- Fontan pressure and systemic oxygen saturation
- Follow-up
- 24 hours postoperation
Main finding
As reported in the abstract
- Adjusting for clinical covariates, higher preoperative ET1 was associated with higher 24-hour Fontan pressure
- Higher 24-hour postoperative ET1 was associated with lower systemic oxygen saturation at 24 hours postoperation and higher 24-hour Fontan pressure
- Adjusting for clinical covariates
Observational data: associations, not effects.
Further findings
ET1 in systemic vein, SVHD cases vs controls · lower in SVHD cases
P = 0.001
| Outcome | P value |
|---|---|
| ET1, systemic vein vs pulmonary vein (SVHD cases) · preoperationHigher in systemic vein | P < 0.001 |
- ET1, systemic vein vs pulmonary vein (SVHD cases): systemic vein 1.0 pg/mL
- ET1, systemic vein vs pulmonary vein (SVHD cases): pulmonary vein 0.7 pg/mL
ET1 time course among cases · 2, 24 and 48 hours postoperation
- ET1 concentration peaked at 2 hours postoperation, decreased by 24 hours, and was stable but not back to baseline by 48 hours
Pleural drainage and length of stay
- Higher 24-hour postoperative ET1 was associated with more pleural drainage and longer length of stay
Original publication
Increased Endothelin-1 Is Associated With Morbidity in Single Ventricle Heart Disease in Children Undergoing Fontan Palliation. JACC Adv. Published 20 March 2025. doi:10.
Summarised from the published abstract; every number is checked against it