PMID- 29433731
OWN - NLM
STAT- MEDLINE
DCOM- 20190627
LR  - 20190627
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 121
IP  - 7
DP  - 2018 Apr 1
TI  - Relation of Increased Epicardial Fat After Fontan Palliation to Cardiac Output 
      and Systemic Ventricular Ejection Fraction.
PG  - 862-866
LID - S0002-9149(18)30046-8 [pii]
LID - 10.1016/j.amjcard.2017.12.026 [doi]
AB  - Epicardial fat produces multiple proinflammatory cytokines and is associated with 
      adverse cardiovascular events. Inflammation and resultant endothelial dysfunction 
      may play a role in progressive myocardial dysfunction among adults with single 
      ventricle physiology after Fontan palliation, but the potential impact of 
      increased epicardial fat volume (EFV) has not been studied. This study sought to 
      determine if there is greater EFV in Fontan patients compared with a group of 
      repaired tetralogy of Fallot (rTOF) patients. We retrospectively measured EFV 
      manually on cardiac magnetic resonance imaging in Fontan patients, >/=15 years, and 
      1:1 age, sex, and body mass index-matched patients with rTOF. EFV was indexed to 
      body surface area. A random subset of studies was re-measured to assess intra- 
      and interobserver reliability. Fontan patients (n = 63, median age 21.6 years, 
      51% male, mean body mass index 24.2 +/- 5.6 kg/m(2)) had a larger indexed EFV 
      compared with matched rTOF patients (75.3 +/- 29.2 ml/m(2) vs 60.0 +/- 19.9 ml/m(2), 
      p = 0.001). In Fontan patients, indexed EFV was inversely correlated with 
      ventricular ejection fraction (r = -0.26, p = 0.04) and cardiac index (r = -0.33, 
      p = 0.01). Intra- and interobserver reliabilities of the indexed EFV measurements 
      in both groups were excellent (intraclass correlation coefficient ranges from 
      0.93 to 0.97). In conclusion, indexed EFV is higher in Fontan patients compared 
      with patients with rTOF and is associated with lower ventricular ejection 
      fraction and cardiac index. Increased EFV could play a role in the failing Fontan 
      circulation, but longitudinal studies are necessary to establish any causative 
      role.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Lubert, Adam M
AU  - Lubert AM
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Michigan, Mott Children's Hospital, Ann Arbor, Michigan. Electronic address: 
      luberta@med.umich.edu.
FAU - Lu, Jimmy C
AU  - Lu JC
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Michigan, Mott Children's Hospital, Ann Arbor, Michigan; Department of Radiology, 
      Section of Pediatric Radiology, University of Michigan, Ann Arbor, Michigan.
FAU - Rocchini, Albert P
AU  - Rocchini AP
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Michigan, Mott Children's Hospital, Ann Arbor, Michigan.
FAU - Norris, Mark D
AU  - Norris MD
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Michigan, Mott Children's Hospital, Ann Arbor, Michigan.
FAU - Yu, Sunkyung
AU  - Yu S
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Michigan, Mott Children's Hospital, Ann Arbor, Michigan.
FAU - Agarwal, Prachi P
AU  - Agarwal PP
AD  - Division of Cardiothoracic Radiology, Department of Radiology, University of 
      Michigan, Ann Arbor, Michigan.
FAU - Ghadimi Mahani, Maryam
AU  - Ghadimi Mahani M
AD  - Department of Radiology, Section of Pediatric Radiology, University of Michigan, 
      Ann Arbor, Michigan; Division of Cardiothoracic Radiology, Department of 
      Radiology, University of Michigan, Ann Arbor, Michigan.
FAU - Dorfman, Adam L
AU  - Dorfman AL
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Michigan, Mott Children's Hospital, Ann Arbor, Michigan; Department of Radiology, 
      Section of Pediatric Radiology, University of Michigan, Ann Arbor, Michigan.
LA  - eng
PT  - Journal Article
DEP - 20180109
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - Pulmonary Atresia with Intact Ventricular Septum
SB  - IM
MH  - Adipose Tissue/*diagnostic imaging
MH  - Adolescent
MH  - Adult
MH  - Body Mass Index
MH  - Cardiac Output/*physiology
MH  - Female
MH  - *Fontan Procedure
MH  - Heart Defects, Congenital/diagnostic imaging/*physiopathology/surgery
MH  - Humans
MH  - Hypoplastic Left Heart Syndrome/diagnostic imaging/*physiopathology/surgery
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Pericardium/*diagnostic imaging
MH  - Pulmonary Atresia/diagnostic imaging/*physiopathology/surgery
MH  - Retrospective Studies
MH  - Stroke Volume/*physiology
MH  - Tetralogy of Fallot/diagnostic imaging/*physiopathology/surgery
MH  - Tricuspid Atresia/diagnostic imaging/*physiopathology/surgery
MH  - Young Adult
EDAT- 2018/02/13 06:00
MHDA- 2019/06/30 06:00
CRDT- 2018/02/14 06:00
PHST- 2017/10/25 00:00 [received]
PHST- 2017/12/15 00:00 [revised]
PHST- 2017/12/29 00:00 [accepted]
PHST- 2018/02/13 06:00 [pubmed]
PHST- 2019/06/30 06:00 [medline]
PHST- 2018/02/14 06:00 [entrez]
AID - S0002-9149(18)30046-8 [pii]
AID - 10.1016/j.amjcard.2017.12.026 [doi]
PST - ppublish
SO  - Am J Cardiol. 2018 Apr 1;121(7):862-866. doi: 10.1016/j.amjcard.2017.12.026. Epub 
      2018 Jan 9.