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Related Concept Videos

Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

Imaging Studies for Cardiovascular System II:Types of Echocardiography

401
Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
401

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Related Experiment Video

Updated: Sep 20, 2025

Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography
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Semi-Invasive Pressure-Flow Plots Obtained Using Exercise Echocardiography Relate to Clinical Status and Exercise

Aleksandra Cieplucha1, Hannah Van Belle2, William R Miranda3

  • 1Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|May 23, 2025
PubMed
Summary

A steeper peripheral venous pressure to cardiac output (PVP/CO) slope in Fontan patients indicates worse clinical status and lower exercise capacity. This finding supports the use of exercise echocardiography with peripheral venous pressure measurement (CPETecho-PVP) in Fontan patient care.

Keywords:
Adult congenital heart diseaseExercise echocardiographyFailing FontanFontan patientsPressure-flow plots

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Physiology

Background:

  • Fontan-associated heart failure poses significant challenges.
  • Standard cardiopulmonary exercise testing (CPET) may not fully capture Fontan pathophysiology.
  • Exercise echocardiography with peripheral venous pressure measurement (CPETecho-PVP) offers potential for deeper insights.

Purpose of the Study:

  • To assess the clinical and hemodynamic correlates of pressure-flow plots from CPETecho-PVP in Fontan patients.
  • To determine the relationship between these pressure-flow plots and patient exercise capacity.

Main Methods:

  • Forty-one Fontan patients underwent CPETecho-PVP.
  • Peripheral venous pressure (PVP) was measured in the distal upper extremity.
  • A PVP/cardiac output (CO) slope was calculated; an elevated slope was defined as >3 mm Hg/L/min.

Main Results:

  • A steeper PVP/CO slope (>3 mm Hg/L/min) was linked to higher NYHA functional class (III-IV), lung pathology, atrial arrhythmia, and thromboembolism.
  • Patients with elevated PVP/CO slopes had higher NT-proBNP levels, lower peak oxygen consumption (VO2), reduced heart rate reserve, and lower peak cardiac index.
  • Rest-to-peak changes in heart rate and cardiac index, forced vital capacity, and PVP/CO slope all correlated with predicted peak VO2.

Conclusions:

  • A steeper PVP/CO slope is a significant indicator of poorer clinical status and diminished exercise capacity in Fontan patients.
  • These findings advocate for the integration of CPETecho-PVP into the standard clinical management of Fontan patients.