دورية أكاديمية
أعرض في EDS

Noninvasive Advanced Cardiovascular Magnetic Resonance-Derived Fontan Hemodynamics Are Associated With Reduced Kidney Function But Not Albuminuria.

التفاصيل البيبلوغرافية
العنوان: Noninvasive Advanced Cardiovascular Magnetic Resonance-Derived Fontan Hemodynamics Are Associated With Reduced Kidney Function But Not Albuminuria.
المؤلفون: Van den Eynde J; Department of Pediatrics, Division of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands.; Department of Cardiothoracic Surgery Leiden University Medical Center Leiden The Netherlands.; Congenital and Structural Cardiology University Hospitals Leuven Leuven Belgium.; Department of Cardiovascular Sciences Catholic University Leuven Leuven Belgium., Westenberg JJM; CardioVascular Imaging Group, Department of Radiology Leiden University Medical Center Leiden The Netherlands., Hazekamp MG; Department of Cardiothoracic Surgery Leiden University Medical Center Leiden The Netherlands., Lamb HJ; CardioVascular Imaging Group, Department of Radiology Leiden University Medical Center Leiden The Netherlands., Jongbloed MRM; Department of Cardiology Leiden University Medical Center Leiden The Netherlands.; Department of Anatomy & Embryology Leiden University Medical Center Leiden The Netherlands., Wentzel JJ; Department of Cardiology Biomechanical Engineering, Erasmus MC Rotterdam The Netherlands., Kenjeres S; Department of Chemical Engineering, Faculty of Applied Sciences Delft University of Technology Delft The Netherlands.; J.M. Burgers Centrum Research School for Fluid Mechanics Delft The Netherlands., Dekkers IA; CardioVascular Imaging Group, Department of Radiology Leiden University Medical Center Leiden The Netherlands., Van De Bruaene A; Congenital and Structural Cardiology University Hospitals Leuven Leuven Belgium.; Department of Cardiovascular Sciences Catholic University Leuven Leuven Belgium., Rijnberg FM; Department of Cardiothoracic Surgery Leiden University Medical Center Leiden The Netherlands., Roest AAW; Department of Pediatrics, Division of Pediatric Cardiology Leiden University Medical Center Leiden The Netherlands.
المصدر: Journal of the American Heart Association [J Am Heart Assoc] 2024 Feb 06; Vol. 13 (3), pp. e033122. Date of Electronic Publication: 2024 Jan 31.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford : Wiley-Blackwell
مواضيع طبية MeSH: Heart Defects, Congenital*/diagnostic imaging , Heart Defects, Congenital*/surgery , Fontan Procedure*/adverse effects , Fontan Procedure*/methods, Adolescent ; Young Adult ; Humans ; Male ; Female ; Creatinine ; Albuminuria/etiology ; Hemodynamics ; Kidney ; Magnetic Resonance Spectroscopy ; Albumins
مستخلص: Background: Kidney disease is the most important predictor of death in patients with a Fontan circulation, yet its clinical and hemodynamic correlates have not been well established.
Methods and Results: A total of 53 ambulatory patients with a Fontan circulation (median age, 16.2 years, 52.8% male patients) underwent advanced cardiovascular magnetic resonance assessment, including 4-dimensional flow imaging and computational fluid dynamics. Estimated glomerular filtration rate (eGFR) <90 mL/min per 1.73 m 2 was observed in 20.8% and albumin-to-creatinine ratio >3 mg/mmol in 39.6%. The average eGFR decline rate was -1.83 mL/min per 1.73 m 2 per year (95% CI, -2.67 to -0.99; P <0.001). Lower eGFR was associated with older age, larger body surface area at examination, longer time since Fontan procedure, and lower systemic ventricular ejection fraction. Higher albumin-to-creatinine ratio was associated with absence of fenestration at the Fontan operation, and older age and lower systemic ventricular ejection fraction at the assessment. Lower cross-sectional area of the Fontan conduit indexed to flow (r=0.32, P =0.038), higher inferior vena cava-conduit velocity mismatch factor (r=-0.35, P =0.022), higher kinetic energy indexed to flow in the total cavopulmonary connection (r=-0.59, P =0.005), and higher total cavopulmonary connection resistance (r=-0.42, P =0.005 at rest; r=-0.43, P =0.004 during exercise) were all associated with lower eGFR but not with albuminuria.
Conclusions: Kidney dysfunction and albuminuria are common among clinically well adolescents and young adults with a Fontan circulation. Advanced cardiovascular magnetic resonance-derived metrics indicative of declining Fontan hemodynamics are associated with eGFR and might serve as targets to improve kidney health. Albuminuria might be driven by other factors that need further investigation.
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فهرسة مساهمة: Keywords: Fontan; albuminuria; chronic kidney disease; computational fluid dynamics; hemodynamics; kidney function; magnetic resonance imaging
المشرفين على المادة: AYI8EX34EU (Creatinine)
0 (Albumins)
تواريخ الأحداث: Date Created: 20240131 Date Completed: 20240207 Latest Revision: 20240430
رمز التحديث: 20240430
مُعرف محوري في PubMed: PMC11056124
DOI: 10.1161/JAHA.123.033122
PMID: 38293946
قاعدة البيانات: MEDLINE
الوصف
تدمد:2047-9980
DOI:10.1161/JAHA.123.033122