Exercise echocardiography combined with peripheral venous pressure measurement (CPETecho-PVP) offers superior pathophysiological insight in Fontan circulation failure compared to standard cardiopulmonary exercise testing.
The study identifies that an elevated peripheral venous pressure to cardiac output (PVP/CO) slope (>3 mm Hg/L/min) is associated with worse clinical status, including higher NYHA class and common Fontan complications.
A steeper PVP/CO slope correlates with lower peak oxygen consumption, diminished heart rate reserve, and reduced cardiac index, indicating impaired exercise capacity.
These findings support integrating CPETecho-PVP into routine clinical evaluation to guide management in adult Fontan patients.
