Thromboembolic Events Are Independently Associated with Liver Stiffness in Patients with Fontan Circulation

被引：9

作者：

Alsaied, Tarek ^{[1
]}

Possner, Mathias ^{[1
]}

Lubert, Adam M. ^{[1
]}

Trout, Andrew T. ^{[2
]}

Gandhi, Janvi P. ^{[3
]}

Garr, BreAnn ^{[4
]}

Palumbo, Joseph S. ^{[5
]}

Palermo, Joseph J. ^{[6
]}

Lorts, Angela ^{[1
]}

Veldtman, Gruschen R. ^{[7
,8
]}

Goldstein, Stuart L. ^{[9
]}

Opotowsky, Alexander ^{[1
]}

Dillman, Jonathan R. ^{[2
]}

机构：

[1] Univ Cincinnati, Coll Med, Cincinnati Childrens Hosp Heart Inst, Dept Pediat, Cincinnati, OH 45229 USA

[2] Univ Cincinnati, Dept Radiol, Coll Med Cincinnati, Cincinnati, OH 45229 USA

[3] Cincinnati Childrens Hosp Med Ctr, Summer Undergraduate Res Fellowship, Cincinnati, OH 45229 USA

[4] Cincinnati Childrens Hosp Med Ctr, Heart Inst, Div Pharm, Cincinnati, OH 45229 USA

[5] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Div Hematol, Dept Pediat,Coll Med, Cincinnati, OH 45229 USA

[6] Univ Cincinnati, Coll Med, Dept Pediat, Cincinnati Childrens Hosp Med Ctr,Div Gastroenter, Cincinnati, OH 45229 USA

[7] Cincinnati Childrens Hosp & Heart Ctr, Adult Congenital Heart Dis, Riyadh 45229, Saudi Arabia

[8] King Faisal Specialist Hosp & Res Ctr, Riyadh 45229, Saudi Arabia

[9] Cincinnati Childrens Hosp Med Ctr, Div Nephrol, Cincinnati, OH 45229 USA

来源：

JOURNAL OF CLINICAL MEDICINE | 2020年 / 9卷 / 02期

关键词：

Fontan operation; single ventricle congenital heart disease; coagulation; thromboembolism; anticoagulation; liver stiffness; TOTAL CAVOPULMONARY CONNECTION; IMAGING MR ELASTOGRAPHY; PRIMARY THROMBOPROPHYLAXIS; TRANSIENT ELASTOGRAPHY; RANDOMIZED-TRIAL; FIBROSIS; ABNORMALITIES; COMPLICATIONS; COAGULATION; MULTICENTER;

D O I：

10.3390/jcm9020418

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Thromboembolism (TE) and Fontan-associated liver disease (FALD) are common and lead to significant morbidity in Fontan circulations. Risk factors for TE and the potential link between TE and FALD are not well understood. The objective of this study was to evaluate the association between TE and the severity of FALD based on radiologic liver stiffness. Methods: Using a retrospective cohort study design, 85 Fontan patients (aged 27.7 +/- 8.2 years) who had liver stiffness measurement were included. Multivariable logistic regression was used to determine independent associations with TE. Results: Sixteen patients (19%) had a history of TE after the Fontan procedure at a mean age of 21.4 +/- 15.0 years. Patients with TE were significantly older at the time of the last evaluation (33.8 +/- 11.7 vs. 26.3 +/- 6.5 years, p = 0.03). Liver stiffness by MRI and ultrasound was higher in the TE group (5.1 +/- 1.4 vs. 4.3 +/- 1.2 kPa, p = 0.04 and 2.8 +/- 0.4 vs. 2.4 +/- 0.5 m/s, p = 0.04, respectively). On multivariable analysis, higher liver stiffness (odds ratio (OR): 2.12, p = 0.03) and older age (OR: 1.11, p = 0.03) were associated with TE. Conclusions: This study found an association between TE, age, and radiologic liver stiffness.

引用

页数：12

共 38 条

[1] Maldistribution of pulmonary blood flow in patients after the Fontan operation is associated with worse exercise capacity [J].