title: Non-geometric echocardiographic indices of ventricular function in patients with a Fontan circulation.
abstract: BACKGROUND
  Complex anatomy and limited windows complicate echocardiographic assessments of ventricular function in Fontan patients. For the Pediatric Heart Network Fontan Cross-Sectional Study, data were acquired from which mean ventricular pressure change during isovolumetric contraction (dP/dt(ic)), Tei index, and maximal systolic annular velocity (S') could be measured. The purpose of this study was to compare these nongeometric indices of ventricular function to cardiac magnetic resonance (CMR) measurements of ventricular ejection fraction (EF).
  
  
  METHODS
  Echocardiographic and CMR studies were performed prospectively using standardized protocols; measurements were completed by core laboratories. Data from both modalities were available from 137 patients.
  
  
  RESULTS
  A weak but statistically significant correlation was observed between mean dP/dt(ic) and CMR-derived EF (r = 0.20, P = .022). This correlation was strengthened when preload was taken into account (r = 0.30, P = .001). Statistically significant correlations did not exist between CMR-derived EF and the Tei index or S'.
  
  
  CONCLUSIONS
  Among Fontan patients, the correlation between CMR-derived EF and nongeometric echocardiographic indices of ventricular function is not strong. Of the indices evaluated, however, mean dP/dt(ic) appears to be the best.
authors.affiliation: Children' Hospital Boston and Harvard Medical School, Boston, Massachusetts, USA. jonathan.rhodes@cardio.chboston.org
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rhodes
authors.forename: Renee
authors.initials: R
authors.lastname: Margossian
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Sleeper
authors.forename: Piers
authors.initials: P
authors.lastname: Barker
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bradley
authors.forename: Minmin
authors.initials: M
authors.lastname: Lu
authors.forename: Mark
authors.initials: M
authors.lastname: Fogel
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Harris
authors.forename: Wyman W
authors.initials: WW
authors.lastname: Lai
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Powell
authors.forename: Michael D
authors.initials: MD
authors.lastname: Puchalski
authors.forename: Girish
authors.initials: G
authors.lastname: Shirali
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colan
mesh_terms: D000293:Adolescent; D002648:Child; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D011446:Prospective Studies; D013318:Stroke Volume; D016276:Ventricular Function