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  • Open Access

    ARTICLE

    FibroSURE and elastography poorly predict the severity of liver fibrosis in Fontan-associated liver disease

    Jessica L. Schachter1, Manisha Patel2, Samuel R. Horton3, A. Mike Devane4, Alex Ewing5, Gary A. Abrams6

    Congenital Heart Disease, Vol.13, No.5, pp. 764-770, 2018, DOI:10.1111/chd.12650

    Abstract Objective: As the population of patients with Fontan circulation surviving into adult‐ hood increases, hepatic cirrhosis has grown to be a significant cause of morbidity and mortality. Early detection of advanced hepatic fibrosis is imperative for proper inter‐ vention and consideration for heart or combined heart/liver transplantation. Noninvasive biomarkers and elastography have been evaluated for their diagnostic utility with variable results in the Fontan population.
    Design: The cohort included 14 patients age 26.4 SD 7.5 who underwent Fontan surgery. All patients were evaluated with FibroSURE, shear wave elastography (SWE), hepatic duplex sonography, and liver biopsy. Liver fibrosis on biopsy was… More >

  • Open Access

    ARTICLE

    Acoustic radiation force impulse of the liver after Fontan operation: Correlation with cardiopulmonary exercise test

    Michael V. Di Maria1, Lindsey Silverman2, Adel K. Younoszai1, Mariana L. Meyers3, Kelley E. Capocelli4, Michael R. Narkewicz5

    Congenital Heart Disease, Vol.13, No.3, pp. 444-449, 2018, DOI:10.1111/chd.12594

    Abstract Background: The current management paradigm for children with single ventricle heart disease involves a series of palliative surgeries, culminating in the Fontan operation. This physiology results in a high central venous pressure, and in the setting of single ventricle heart disease, results in hepatic injury and fibrosis over time. Fontan-associated liver disease (FALD) is universally present in this cohort, and the current gold standard for diagnosis remains biopsy. Noninvasive assessments of liver fibrosis, such as ultrasound with elastography or acoustic radiation force impulse (ARFI), has been utilized in this cohort. The effect of poor cardiovascular efficiency, as measured by cardiopulmonary… More >

  • Open Access

    ARTICLE

    A composite noninvasive index correlates with liver fibrosis scores in post-Fontan patients: Preliminary findings

    William N. Evans1,2, Ruben J. Acherman1,2, Michael L. Ciccolo1,3, Sergio A. Carrillo1,2, Alvaro Galindo1,2, Abraham Rothman1,2, Gary A. Mayman1,2, Elizabeth A. Adams1,2, Leigh C. Reardon1,4, Brody J. Winn5, Noel S. Yumiaco5, Lesley Shimuizu1, Yoko Inanaga1, Rowena J. Deleon1, Humberto Restrepo1,2

    Congenital Heart Disease, Vol.13, No.1, pp. 38-45, 2018, DOI:10.1111/chd.12558

    Abstract Objective: We hypothesized that clinic-based, hepatic-ultrasound, elastography measurements, either alone or in combination with other noninvasive variables, might correlate with liver-biopsy fibrosis scores in patients post-Fontan.
    Methods: Between March 2012 and February 2017, we identified patients post-Fontan that underwent elective cardiac catheterization and simultaneous transvenous hepatic biopsy. From this group, we selected patients that met inclusion criteria for liver-ultrasound, shear-wave elastography. Utilizing the results of elastography, laboratory testing, and time post-Fontan, we constructed a composite Fontan hepatic index as a sum of elastography measurements in kilopascals, model for end-stage liver disease excluding INR scores, and the square root of the… More >

  • Open Access

    ARTICLE

    Kidney injury biomarkers after cardiac angiography in children with congenital heart disease

    Masashi Nishida, Shingo Kubo, Yuma Morishita, Kosuke Nishikawa, Kazuyuki Ikeda, Toshiyuki Itoi, Hajime Hosoi

    Congenital Heart Disease, Vol.14, No.6, pp. 1087-1093, 2019, DOI:10.1111/chd.12853

    Abstract Objective: This study aims to investigate the changes in renal function and levels of urinary biomarkers before and after cardiac angiography in children with congenital heart disease (CHD).
    Setting: Children with CHD are at a risk for kidney injury during contrast exposure in cardiac angiography.
    Outcome Measures: We measured urinary protein, albumin, N‐acetyl‐β‐D‐glucosaminidase (NAG), β2‐microglobulin (BMG), and liver‐type fatty acid‐binding protein (L‐FABP) levels, as well as serum creatinine and cystatin C levels, before and after cardiac angiography in 33 children with CHD.
    Results: No significant decrease was noted in either the creatinine‐based or cystatin C‐based estimated glomerular filtration rate at… More >

  • Open Access

    ARTICLE

    Assessing hepatic impairment in Fontan‐associated liver disease using the HepQuant SHUNT test

    Alexander Lemmer1, Lisa VanWagner1,2, Zaira Gasanova3, Steve Helmke4,5, Gregory T. Everson4,5, Daniel Ganger1

    Congenital Heart Disease, Vol.14, No.6, pp. 978-986, 2019, DOI:10.1111/chd.12831

    Abstract Background & Aims: Fontan surgery for single ventricle congenital heart disease leads to Fontan‐associated liver disease (FALD). Typical laboratory tests, imaging, and histopathology cannot predict clinical severity in FALD. HepQuant SHUNT is a proprietary serum test of hepatic function and physiology that has not yet been evaluated in FALD.
    Methods: Fourteen adult FALD patients at a single urban tertiary care center who underwent a Fontan procedure in childhood received HepQuant SHUNT testing between September 2015 and April 2018. The HepQuant SHUNT disease severity index (DSI) assesses global liver function and physiology from systemic and portal hepatic filtration rates (HFRs, clearances… More >

  • Open Access

    ARTICLE

    More than the heart: Hepatic, renal, and cardiac dysfunction in adult Fontan patients

    Ryan D. Byrne1, Angela J. Weingarten2, Daniel E. Clark2, Shi Huang3, Roman E. Perri4, Andrew E. Scanga4, Jonathan N. Menachem2, Larry W. Markham5, Benjamin P. Frischhertz2

    Congenital Heart Disease, Vol.14, No.5, pp. 765-771, 2019, DOI:10.1111/chd.12820

    Abstract Setting: Fontan‐associated liver disease universally affects adults with single ventricle heart disease. Chronic kidney disease is also highly prevalent in adult Fontan patients. In this study, we evaluate the relationship of Fontan hemodynamics invasively and noninvasively with extra‐cardiac dysfunction as measured by MELD and MELD‐XI.
    Objective: We hypothesize that invasive and noninvasive measures of Fontan circuit congestion and ventricular dysfunction are associated with increased MELD and MELD‐XI scores.
    Design: Single‐center data from adults with Fontan palliation who had ongoing care, including cardiac catheterization, were retrospectively collected. Hemodynamic data from cardiac catheterization and echocardiographic assessment of ventricular and atrioventricular valve function… More >

  • Open Access

    ARTICLE

    Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

    Natalie Bottega1, Isabelle Malhamé2, Liming Guo1, Raluca Ionescu‐Ittu1, Judith Therrien1, Ariane Marelli1

    Congenital Heart Disease, Vol.14, No.5, pp. 735-744, 2019, DOI:10.1111/chd.12811

    Abstract Background: The number of women with congenital heart disease (CHD) of reproductive age is increasing, yet a description of trends in pregnancy and delivery outcomes in this population is lacking.
    Objective: To assess secular trends in pregnancy rates, delivery outcomes, and related health care utilization in the adult female CHD population in Quebec, Canada.
    Methods: The Quebec CHD database was used to construct a cohort with all women with CHD aged 18‐45 years between 1992 and 2004. Pregnancy and delivery rates were determined yearly and compared to the general population. Secular trends in pregnancy and delivery rates were assessed with… More >

  • Open Access

    ARTICLE

    Focal liver lesions following Fontan palliation of single ventricle physiology: A radiology‐pathology case series

    Emily M. Engelhardt1, Andrew T. Trout2,3, Rachel M. Sheridan4, Gruschen R. Veldtman5, Jonathan R. Dillman2,3

    Congenital Heart Disease, Vol.14, No.3, pp. 380-388, 2019, DOI:10.1111/chd.12730

    Abstract Purpose: Patients who have undergone Fontan palliation of single ventricle physiol‐ ogy congenital heart disease are prone to developing focal liver lesions. In our experi‐ ence, the variety of lesions occurring in this population is greater than that described in the literature. The purpose of this study was to describe the breadth of biopsy‐ proven liver lesions in patients post–Fontan palliation of single ventricle physiology cared for at our institution.
    Methods: We retrospectively identified patients who had previously undergone the Fontan operation and had a focal liver lesion biopsied between January 2000 and June 2018. Medical records were reviewed for… More >

  • Open Access

    REVIEW

    Role of pyroptotic cell death in the pathogenesis of NASH

    Yuguo YI, Jiamin ZHENG, Yang ZHOU, Zhiqin LIU, Dan WENG*

    BIOCELL, Vol.44, No.1, pp. 7-11, 2020, DOI:10.32604/biocell.2020.08686

    Abstract Nonalcoholic fatty liver disease (NAFLD) represents a huge threat to public health of the whole world. Around 25% of NAFLD patients will progress to nonalcoholic steatohepatitis (NASH), which has been predicted to be the main reason for liver transplantation in the United States in 2020. Extensive effort has been devoted to investigating the underlying molecular mechanisms of NASH pathogenesis and developing new promising treatments. Recent studies have demonstrated that pyroptosis, an inflammatory programmed cell death mediated by inflammasome and gasdermin-D (GSDMD), is involved in the development and progression of NASH. This review aims to summarize the recent findings regarding the… More >

  • Open Access

    ARTICLE

    Empirical Comparisons of Deep Learning Networks on Liver Segmentation

    Yi Shen1, Victor S. Sheng1, 2, *, Lei Wang1, Jie Duan1, Xuefeng Xi1, Dengyong Zhang3, Ziming Cui1

    CMC-Computers, Materials & Continua, Vol.62, No.3, pp. 1233-1247, 2020, DOI:10.32604/cmc.2020.07450

    Abstract Accurate segmentation of CT images of liver tumors is an important adjunct for the liver diagnosis and treatment of liver diseases. In recent years, due to the great improvement of hard device, many deep learning based methods have been proposed for automatic liver segmentation. Among them, there are the plain neural network headed by FCN and the residual neural network headed by Resnet, both of which have many variations. They have achieved certain achievements in medical image segmentation. In this paper, we firstly select five representative structures, i.e., FCN, U-Net, Segnet, Resnet and Densenet, to investigate their performance on liver… More >

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