A Tense Race:Correlation of Liver Stiffness with Ultrasound Elastographyand Hemodynamics in Fontan PatientsOA

Background:Patients with Fontan physiology are predisposed to congestive hepatopathy,progressive liver fib rosis,and end-stage liver disease.Ulrasound-based shear wave elastography(SWE)is a non-invasive tool to diagnose and mnonitor liver fibrosis,We sought to deternine whether the degreeof hemodynanic derangement priorto and after the Fontan operation is associated with irncreased liverstiffness measured by SWE.Methods:A single-center retrospectivestudy of patients with Pontan circulationwho underwert ultrasound elastography between 2008 and 2024 was conducted,Liver stiffness wasmeasuued by SWE and teported as vlocity in n/s.Henodynanic assessmert with catrdiac cathetaizationand echocardiograms were collected before and after the Fontan operation,Data was analyzed as acontinuous(lineat regression model)and a dichotomous variable(t-test).Results:78 pcst-Fortan ultrasoundelactography studies pt fotmedin 56 patients wee analyzed.Pre-Fontan hemnodyrnarrics ircluded medianeffective pulmonary flow of 2.45 L/min/m^(2)[2.21,3.16](p=0.46)ventricular end-diastolic pressure of10 mmHg[8,10.5](p=0.77),and median Glenn ptessue of 12 mmHg[13,15](p=0.83).Post-Fontan mediansystemnic cardiac index was 2.80 L/min/m^(2)[2.4,3.34](p=0.93),median ventricular end-diastolic pressureof 12 mmHg[13.5,14](p=0.99),median systenic saturation of 93%[87,96](p=0.77),median indexedpulmonary vasculat resistance of 1.80 WU·m^(2)[1.49,2.37](p=0.93),and median Fontan ptessue of 18 mmHg[16,21](p=0.86).No corelation was found between SWE and hemodynamics.On echoc ardiography,no correlation was found between SWE and systenic vantricular systolic function(p=0.35)or degree ofsystenic atriovertricula valve regurgitation (p=0.35).Conclusions:The degree of liver stffness by SWEinthis cohort did not correlate withpre and post-Fontan hermodynarnics on cat diac catheterization,degr ee ofverntriculat dysfuntiony or severity of atrioventriculat valve regurgitation by echocardiography.