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

Tarek Alsaied, Mathias Possner, Adam M Lubert, Andrew T Trout, Janvi P Gandhi, BreAnn Garr, Joseph S Palumbo, Joseph J Palermo, Angela Lorts, Gruschen R Veldtman, Stuart L Goldstein, Alexander Opotowsky & Johnathan R Dillman

abstract 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. 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. 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, = 0.03). Liver stiffness by MRI and ultrasound was higher in the TE group (5.1 ± 1.4 vs. 4.3 ± 1.2 kPa, = 0.04 and 2.8 ± 0.4 vs. 2.4 ± 0.5 m/s, = 0.04, respectively). On multivariable analysis, higher liver stiffness (odds ratio (OR): 2.12, = 0.03) and older age (OR: 1.11, = 0.03) were associated with TE. This study found an association between TE, age, and radiologic liver stiffness.
   
citation Alsaied T, Possner M, Lubert A M, Trout A T, Gandhi J P, Garr B, Palumbo J S, Palermo J J, Lorts A, Veldtman G R, Goldstein S L, Opotowsky A, Dillman J R. Thromboembolic Events Are Independently Associated with Liver Stiffness in Patients with Fontan Circulation. J Clin Med 2020; 9:.
   
type journal paper/review (English)
date of publishing 04-02-2020
journal title J Clin Med (9/2)
ISSN print 2077-0383
PubMed 32032996
DOI 10.3390/jcm9020418