Abstract 15117: Cardiac Mechanics in Single Ventricle Patients after the Fontan Procedure: Analysis of the Pediatric Heart Network Multicenter Study Cardiac Magnetic Resonance Database Compared to Outcome Parameters
Background Cardiac function assessment is critical in caring for an increasing single ventricle (SV) patient population. Strain and strain rate (SR), determined by feature-tracking applied to cardiac magnetic resonance imaging (MRI), reflect myocardial contractile function and are significantly different in SV compared to normals.
Methods This is a study of the Fontan Cross-Sectional Study of the Pediatric Heart Network, which allowed us to analyze the MRI database. Included are patients, 6-18years, post Fontan procedure >6 months prior to enrollment. Post-processing feature-tracking analysis with Velocity Vector Imaging (VVI) was performed on long axis (LAX) and short axis (SAX) (papillary muscle level) views from gradient-cine MRIs. Longitudinal and radial strain and SR from LAX, circumferential and radial strain and SR, rotational displacement and velocity from SAX were generated. Multiple linear regression for continuous clinical variables and multiple logistic regression for categorical clinical variables were performed. Predictors to be included were chosen by stepwise selection.
Results Twenty-six of 166 studies were excluded for lack of sequences or unsuccessful tracking. One-hundred forty studies on 140 patients were included: 132 and 130 successful LAX and SAX analysis, respectively. Importantly, there were association with child global health survey (adjusted-R2=0.08, p=0.007) and arrhythmia (adjusted-R2=0.07, p<0.001). Ventricular morphology (adjusted-R2=0.09, p<0.001), Fontan type (adjusted-R2=0.07, p=0.002), MRI ejection fraction (adjusted-R2=0.17; p<0.001) and ventricular mass (adjusted-R2=0.12; p<0.001) also had statistically significant associations with selected VVI parameters.
Conclusions Cardiac mechanic parameters measured by MRI are associated with presence/absence of arrhythmia and child global health survey outcomes in Fontan patients, and may aid in follow-up and management of post-Fontan patients.
- © 2012 by American Heart Association, Inc.