Global strain and dyssynchrony of the single ventricle predict adverse cardiac events after the Fontan procedure: Analysis using feature-tracking cine magnetic resonance imaging

Ishizaki, Umiko; Nagao, Michinobu; Shiina, Yumi; Inai, Kei; Mori, Hiroki; Takahashi, Tatsunori; Sakai, Shuji

doi:10.1016/j.jjcc.2018.07.005

Cited by 24 publications

(23 citation statements)

References 27 publications

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“…In Fontan patients, global longitudinal strain as measured by CMR-TT has been shown to be an independent predictor of major adverse cardiovascular events. Importantly, we found that global longitudinal strain, a marker of systolic function, improved significantly with probenecid suggesting an improvement in intrinsic contractility following treatment [16]. In addition, we found a trend towards an improvement in diastolic strain with treatment suggesting some improvement of diastolic function consistent with augmentation of diastolic Ca 2+ homeostasis observed in ex vivo experiments.…”

Section: Discussionsupporting

confidence: 73%

“…Strain measurements have been repeatedly used as a more sensitive marker to evaluate myocardial function compared to ejection fraction in Fontan patients and other populations. The changes in strain often precede any changes in ejection fraction and thus can serve as a treatment target in heart failure [16,18]. Longitudinal strain is used clinically in multiple settings due to reproducibility and sensitivity to many pathologies, for example, as the standard of care to evaluate ventricular function in patients after anthracycline chemotherapy [16,41].…”

Section: Discussionmentioning

confidence: 99%

“…Systolic function can also be impaired in this condition, and cardiac magnetic resonance imaging with tissue tracking (CMR-TT) recently demonstrated prognostic value in myocardial strain. Indeed, Ishizaki and colleagues found that global longitudinal strain (GLS) using CMR-TT was an independent predictor of major adverse cardiac events (MACE) [16]. Cardiac magnetic resonance (CMR) is the reference standard to evaluate ventricular volume, mass, and function of the single ventricle [17,18].…”

Section: Introductionmentioning

confidence: 99%

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Probenecid Improves Cardiac Function in Subjects with a Fontan Circulation and Augments Cardiomyocyte Calcium Homeostasis

et al. 2020

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Subjects with functionally univentricular circulation who have completed staged single ventricle palliation, with the final stage culminating in the Fontan procedure, are often living into adulthood. However, high morbidity and mortality remain prevalent in these patients, as diastolic and systolic dysfunction of the single systemic ventricle are linked to Fontan circulatory failure.We presently investigated the effects of probenecid in post-Fontan patients. Used for decades for the treatment of gout, probenecid has been shown in recent years to positively influence cardiac function via effects on the Transient Receptor Potential Vanilloid 2 (TRPV2) channel in cardiomyocytes. Indeed, we observed that probenecid improved cardiac function and exercise performance in patients with a functionally univentricular circulation. This was consistent with our findings from a retrospective cohort of patients with single ventricle physiology where TRPV2 expression was increased. Experiments in isolated cardiomyocytes associated these positive actions to augmentation of diastolic calcium homeostasis.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Probenecid Improves Cardiac Function in Subjects with a Fontan Circulation and Augments Cardiomyocyte Calcium Homeostasis

et al. 2020

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“…HF is a major cause of death in adults with Fontan circulation as well as other complex CHD [23,24]. Growth hormone released from skeletal muscle modulates gastrointestinal, cardiovascular, pulmonary, immune functions, and cell proliferation/apoptosis [12].…”

Section: ) Sarcopenia and Hf In Fontan Circulationmentioning

confidence: 99%

Secondary sarcopenia assessed by computed tomography can predict hospitalization for heart failure in adults with Fontan circulation

Shiina

Nagao

Shimomiya

et al. 2021

Journal of Cardiology

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Sarcopenia is a loss of muscle mass and function [1]. This phenomenon occurs not only in elderly people but also in patients with chronic illnesses such as, chronic heart failure (HF), liver dysfunction, and kidney dysfunction [1-5], which is called secondary sarcopenia. Possible explanations for sarcopenia include an abnormal energy metabolism coupled with mitochondrial dysfunction as well as a change in the structure of the myofibers, malnutrition, systemic inflammation, and oxidative stress [6][7][8][9].Recent studies have reported that secondary sarcopenia is not rare in adults with congenital heart disease (CHD) [10,11]. Sarcopenia is one of the important predictors of HF in non-CHD [12][13][14]; whereas, it remains unclear whether sarcopenia is also relevant to prognosis in adults with CHD. In particular, skeletal muscle function is important in Fontan circulation because a passive blood flow in a Fontan route can be maintained by both skeletal muscle pumping and the change of intrapleural pressure (ventilatory pumping) [15][16][17]. However, it is challenging to measure the entire skeletal muscle mass; until now, dual energy X-ray absorptiometry or bioelectrical impedance analysis (BIA) has been used to measure it [1,2]. The former method needs special equipment, and the latter is not available to patients after pacemaker implantation. The biggest issue in adults with Fontan circulation is that most patients have already undergone pacemaker implantation; therefore,

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“…Indexed end-diastolic volume > 125 mL/m 2 measured using MRI is an independent predictor of a poor Fontan outcome, including transplantation or death (74). Furthermore, global strain and dyssynchrony of the single ventricle measured using feature-tracking cine MRI are independent predictors of major adverse cardiac events in these patients (75).…”

Section: Ventricular Functionmentioning

confidence: 99%

CT and MRI for Repaired Complex Adult Congenital Heart Diseases

Siripornpitak

Goo

2021

Korean J Radiol

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Advances in the diagnosis and treatment of pediatric congenital heart disease have resulted in improved survival rates, with many repaired patients reaching adulthood. In cases of adult congenital heart disease (ACHD), patients typically undergo palliative and/or corrective treatment with either a surgical, interventional, or hybrid procedure. The resultant changes in the cardiovascular anatomy and physiology are subject to long-term imaging followup to ensure adaptive responses and identify potential complications early on. The recommended frequency and modality for imaging follow-up is based on the underlying disease, mode of correction, and functional status as well as strengths and weaknesses of each modality (1).

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Global strain and dyssynchrony of the single ventricle predict adverse cardiac events after the Fontan procedure: Analysis using feature-tracking cine magnetic resonance imaging

Abstract: GLS and the dyssynchrony index found using CMR-FT are independent predictors of MACE for adolescent patients after the Fontan procedure and provide information regarding risk stratification beyond clinical parameters and biomarkers.

Cited by 24 publications

References 27 publications

Probenecid Improves Cardiac Function in Subjects with a Fontan Circulation and Augments Cardiomyocyte Calcium Homeostasis

Probenecid Improves Cardiac Function in Subjects with a Fontan Circulation and Augments Cardiomyocyte Calcium Homeostasis

Secondary sarcopenia assessed by computed tomography can predict hospitalization for heart failure in adults with Fontan circulation

CT and MRI for Repaired Complex Adult Congenital Heart Diseases

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