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...
| Publicado en: | Echocardiography Vol. 42; no. 9; pp. 1 - 12 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188159104&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188159104 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Sep2025 vid: 42 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 188159104 188159104 188159104 10.1111/echo.70297 188159104 ppf: 1 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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