Role of strain imaging for risk stratification in Fontan patients with normal ventricular ejection fraction
Authors' conclusion
Echo_LS improves risk stratification in Fontan patients with normal Echo_EF and may provide an opportunity for early interventions to improve outcomes.
Study context
- Population
- Adults with Fontan palliation and normal systemic ventricular (SV) systolic function (Echo_EF >50%) at baselineage, 28 ± 8 years
- Participants
- 272 adults
- Comparison
- Reduced vs. normal Echo_LS
- Reduced Echo_LSn = 98
- Normal Echo_LSn = 174reference
- Outcome
- Temporal decline in Echo_EF (relative_Δ_Echo_EF)
Methodological detailsspeckle tracking echocardiography, follow-up echocardiogram >36 months after the baseline echocardiogram
- Speckle tracking echocardiography
- Follow-up echocardiogram >36 months after the baseline echocardiogram
Main finding
As reported in the abstract
Reduced Echo_LS
−12.8%
Normal Echo_LS
−2.1%
P < 0.001
Further findings
New-onset SV systolic dysfunction · higher prevalence with reduced Echo_LS
P < 0.001
%
| Outcome | Reduced Echo_LS | Normal Echo_LS | Adjusted hazard ratio | P value |
|---|---|---|---|---|
| Neurohormonal activation (relative Δ_ NT-proBNP)Greater with reduced Echo_LS | 36 (95% CI 27–43) | 17 (95% CI 11–23) | P < 0.001 | |
| Cardiovascular events (heart failure hospitalization/death/transplant)Adjusted | 1.84 | P = 0.009 |
Original publication
Role of strain imaging for risk stratification in Fontan patients with normal ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. Published 1 July 2025. doi:10.
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