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| Autores principales: | , , , |
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| Formato: | Artículo Open Access |
| Publicado: |
Wiley
2025
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| Materias: | |
| Acceso en línea: | https://onlinelibrary.wiley.com/doi/10.1111/echo.70297 |
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- Association of Global Longitudinal Strain and Long‐Term Transplant‐Free Survival in Fontan Patients Assami Rösner Simone Goa Diab Mark K. Friedberg George K. Lui Echocardiography ABSTRACTBackground and ObjectivesPatients with single‐ventricle physiology undergoing Fontan operations face high morbidity and mortality risks. While classic‐pattern dyssynchrony (CPD) and protein‐losing enteropathy (PLE) are known predictors of adverse outcomes, the role of global longitudinal strain (GLS) as an independent predictor of heart failure remains unclear.MethodsA retrospective cohort study of 135 Fontan‐operated patients from 2014 to 2015 evaluated the predictive value of GLS alongside PLE and CPD on mortality and transplantation after 9 years. Echocardiographic data, including GLS, were analyzed using speckle tracking strain analysis in 132 patients. The primary endpoint was transplant‐free survival.ResultsAmong 132 Fontan patients, 15 had classic‐pattern dyssynchrony, 29 had protein‐losing enteropathy, 37 had moderately reduced global longitudinal strain (GLS ←8% ≥–16%), and 18 had severely reduced GLS (≥–8%). Cox regression analysis showed moderately reduced GLS increased mortality risk (HR 5.8, 95% CI 1.27–26.5, p = 0.023), with severely reduced GLS showing an HR of 10.3 (95% CI 2.18–48.6, p = 0.003). These results were comparable to CPD (HR 11.5, p = 0.002) and PLE (HR 14.9, p < 0.001).ConclusionGlobal longitudinal strain emerged as the best independent factor for predicting long‐term transplant‐free survival in Fontan patients, highlighting the importance of GLS assessment in routine follow‐up to identify high‐risk individuals for early intervention. 10.1111/echo.70297 http://onlinelibrary.wiley.com/termsAndConditions#vor