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April 8, 2026Journal of Cardiovascular Magnetic ResonanceOpen Access

CMR yielded higher Qp/Qs values than catheterization, which underestimated Qp/Qs by a mean of 0.41, a difference strongly correlated with aortopulmonary collateral burden (p<0.0001).

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Why the study?

Does CMR provide superior quantification of Qp/Qs and aortopulmonary collateral burden compared to cardiac catheterization in children undergoing pre-Fontan evaluation?

Population

57 children with single ventricle (SV) physiology undergoing pre-Fontan evaluation

Comparison

Cardiac magnetic resonance imaging assessment vs Cardiac catheterization (Cath) assessment

Design

Cohort

Key result

CMR yielded higher Qp/Qs values than catheterization, which underestimated Qp/Qs by a mean of 0.41, a difference strongly correlated with aortopulmonary collateral burden (p<0.0001).

Authors

ASAshish ShrivastavaRHRussel HirschSSShabana Shahanavaz

Discussion

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Overview

Combined CMR and catheterization provides comprehensive pre-Fontan assessment, with CMR offering superior quantification of aortopulmonary collateral burden compared to catheterization alone.

Key Points

  • This study aims to evaluate the effectiveness of combined CMR and catheterization for the pre-Fontan evaluation.
  • Conducted a retrospective analysis in a single-center study
  • Included 57 single-ventricle patients undergoing CMR and catheterization
  • Compared Qp/Qs values between CMR and catheterization
  • Assessed the relationship between APC burden, hemodynamics, and postoperative outcomes
  • CMR provided higher Qp/Qs values than catheterization, with a mean underestimation of 0.41 from Cath
  • Strong correlation found between CMR-derived APC burden and Qp/Qs (p<0.0001)
  • CMR APC burden correlated with increased indexed ventricular volumes and lower ejection fractions
  • Cath-based qualitative APC assessments poorly correlated with CMR findings

Structured PICO

Does CMR provide superior quantification of Qp/Qs and aortopulmonary collateral burden compared to cardiac catheterization in children undergoing pre-Fontan evaluation?

P
Population
57 children with single ventricle (SV) physiology undergoing pre-Fontan evaluation
I
Intervention
Cardiac magnetic resonance imaging (CMR) assessment
C
Comparator
Cardiac catheterization (Cath) assessment
O
Outcome
Comparison of pulmonary and systemic blood flow ratio (Qp/Qs) and aortopulmonary collateral (APC) assessmentssurrogate

Combined CMR and catheterization provides comprehensive pre-Fontan assessment, with CMR offering superior quantification of aortopulmonary collateral burden compared to catheterization alone.

Limitations

  • retrospective design
  • single-center

Cite This Study

Shrivastava et al. (2026) studied this question. CMR yielded higher Qp/Qs values than catheterization, which underestimated Qp/Qs by a mean of 0.41, a difference strongly correlated with aortopulmonary collateral burden (p<0.0001).

synapsesocial.com/papers/69d5f07d74eaea4b11a79f48https://doi.org/10.1016/j.jocmr.2026.102723
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Interventional Cardiovascular Magnetic Resonance in Children Undergoing Pre‐Operative Fontan Evaluation: One‐Stop Shop2025
  2. 2Diagnostic and Prognostic Value of Myocardial Extracellular Volume Fraction Assessed Using Cardiovascular Magnetic Resonance in Patients With Restrictive Cardiac Allograft Physiology2025
  3. 3Fetal 4D Flow CMR for Advanced Diagnostics of Congenital Heart Disease: A Prospective Cohort Study2025 · 2 citations
  4. 4Cardiac magnetic resonance parameters for prognostic stratification in pulmonary hypertension: A longitudinal study2025 · 1 citations
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