Association of Global Longitudinal Strain and Long‐Term Transplant‐Free Survival in Fontan Patients.

Background and Objectives: Patients with single‐ventricle physiology undergoing Fontan operations face high morbidity and mortality risks. While classic‐pattern dyssynchrony (CPD) and protein‐losing enteropathy (PLE) are known predictors of adverse outcomes, the role of global longitudinal strain (G...

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Publicado en:Echocardiography Vol. 42; no. 9; pp. 1 - 12
Autores principales: Rösner, Assami, Diab, Simone Goa, Friedberg, Mark K., Lui, George K.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Association of Global Longitudinal Strain and Long‐Term Transplant‐Free Survival in Fontan Patients.
      aug:
        au:
          Rösner, Assami
          Diab, Simone Goa
          Friedberg, Mark K.
          Lui, George K.
        affil: Department of Cardiology, Division of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, Tromsø, Norway
      sug:
        subj:
          Global Longitudinal Strain
          Heart Defects, Congenital Surgery
          Heart Defects, Congenital Mortality
          Cardiopulmonary Bypass
          Echocardiography
          Heart Ventricle Physiopathology
          Heart Ventricle Radiography
          Heart Transplantation
          Protein-Losing Enteropathies Risk Factors
          Risk Assessment
          Cardiac Surgery
          Treatment Outcomes Evaluation
          Human
          Funding Source
          Male
          Female
          Retrospective Design
          Prospective Studies
          Academic Medical Centers
          Hospitals, Pediatric
          Child
          Adolescence
          ROC Curve
          Chi Square Test
          Analysis of Variance
          Post Hoc Analysis
          Kaplan-Meier Estimator
          Cox Proportional Hazards Model
          Confidence Intervals
          Descriptive Statistics
          Heart Function Tests
          Disease Progression
          Predictive Value of Tests
          Age Factors
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Background and Objectives: Patients with single‐ventricle physiology undergoing Fontan operations face high morbidity and mortality risks. While classic‐pattern dyssynchrony (CPD) and protein‐losing enteropathy (PLE) are known predictors of adverse outcomes, the role of global longitudinal strain (GLS) as an independent predictor of heart failure remains unclear. Methods: A retrospective cohort study of 135 Fontan‐operated patients from 2014 to 2015 evaluated the predictive value of GLS alongside PLE and CPD on mortality and transplantation after 9 years. Echocardiographic data, including GLS, were analyzed using speckle tracking strain analysis in 132 patients. The primary endpoint was transplant‐free survival. Results: Among 132 Fontan patients, 15 had classic‐pattern dyssynchrony, 29 had protein‐losing enteropathy, 37 had moderately reduced global longitudinal strain (GLS ←8% ≥–16%), and 18 had severely reduced GLS (≥–8%). Cox regression analysis showed moderately reduced GLS increased mortality risk (HR 5.8, 95% CI 1.27–26.5, p = 0.023), with severely reduced GLS showing an HR of 10.3 (95% CI 2.18–48.6, p = 0.003). These results were comparable to CPD (HR 11.5, p = 0.002) and PLE (HR 14.9, p < 0.001). Conclusion: Global longitudinal strain emerged as the best independent factor for predicting long‐term transplant‐free survival in Fontan patients, highlighting the importance of GLS assessment in routine follow‐up to identify high‐risk individuals for early intervention.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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