Noninvasive Evaluation of Ventricular Filling Pressure and Pulmonary Vascular Reserve in Adults With Fontan Circulation

Figure 1. Example of how systole and diastole are measured through the dominant atrioventricular valve.

Figure 2. Relationship between S/D and resting PVP for the presence of elevated PAWP at rest or exercise (red dots). The dashed lines highlight the ROC‐optimized cutoffs for S/D (1.1) and PVP (15 mm Hg). PAWP indicates pulmonary artery wedge pressure; PVP, peripheral venous pressure; ROC, receiver operating characteristic; and S/D, systole‐to‐diastole duration ratio.

Figure 3. Proposed assessment algorithm for elevated PAWP at rest or exercise, using S/D, resting PVP, and exercise PVP. PAWP indicates pulmonary artery wedge pressure; PVP, peripheral venous pressure; and S/D, systole‐to‐diastole duration ratio.

Figure 4. Risk of death, transplantation, or hospitalization for heart failure or arrhythmias based on predicted risk of DD by the proposed assessment algorithm. DD indicates diastolic dysfunction.

Figure 5. Haemodynamic predictors of exercise PVRI. Relationship between exercise PVP indexed to peak VO2 (expressed as multiples of 100 mL/min) and exercise PVRI in the whole cohort (A), stratified by elevated PAWP at rest or exercise (B) or predicted risk using the assessment algorithm (C). Relationship between exercise PAP indexed to peak VO2 (expressed as multiples of 100 mL/min) and exercise PVRI (D). PAWP indicates pulmonary artery wedge pressure; PVP, peripheral vein pressure; PVRI, pulmonary vascular resistance index; and VO2, oxygen consumption.