Impact of 4D-Flow CMR Parameters on Functional Evaluation of Fontan Circulation

AbstractWe sought to evaluate the potential clinical role of 4D-flow cardiac magnetic resonance (CMR)-derived energetics and flow parameters in a cohort of patients ’ post-Fontan palliation. In patients with Fontan circulation who underwent 4D-Flow CMR, streamlines distribution was evaluated, as well a 4D-flow CMR-derived energetics parameters as kinetic energy (KE) and energy loss (EL) normalized by volume. EL/KE index as a marker of flow efficiency was also calculated. Cardiopulmonary exercise test (CPET) was also performed in a subgroup of patients. The population study included 55 patients (mean age 22 ± 11 years). The analysis of the streamlines revealed a preferential distribution of the right superior vena cava flow for the right pulmonary art ery (62.5 ± 35.4%) and a mild preferential flow for the left pulmonary artery (52.3 ± 40.6%) of the inferior vena cave-pulmonary arteries (IVC-PA) conduit. Patients with heart failure (HF) presented lower IVC/PA-conduit flow (0.75 ± 0.5 vs 1.3 ± 0.5 l/min/m2,p = 0.004) and a higher mean flow-jet angle of the IVC-PA conduit (39.2 ± 22.8 vs 15.2 ± 8.9,p <  0.001) than the remaining patients. EL/KE index correlates inversely with VO2/kg/min:R: − 0.45,p = 0.01 peak, minute ventilation (VE)R: − 0.466,p <  0.01, maximal voluntary ventilation:R:0.44,p = 0.001 and positively with the physiological dead space to the tidal volume ratio (VD/VT) peak:R: 0.58,p <  0.01. From our data, lower bl...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research