Myocardial fibrosis and ventricular strain indices in post-fontan single ventricle patients: cardiac MR assessment and prognostic significance

Background Staged palliation culminating with the Fontan procedure has dramatically increased survival in children with single ventricle anatomy. However, long-term morbidity and mortality continue to be significant. This has been linked to ventricular myocardial fibrosis and scarring and subsequent altered contractile mechanics with abnormal regional wall motion and strain, but has not been fully elucidated. In this study, we sought to more precisely characterize these structural changes via magnetic resonance imaging and quantitatively assess ventricular mechanics through the measurement and calculation of MRI-derived displacement fields and regional wall strain to discern any association between fibrosis and function in the post-Fontan population.