Non-invasive liver tests predict survival in complex congenital heart disease
A major retrospective study in Heart has identified non-invasive biomarkers of liver fibrosis as significant prognostic indicators for patients with Fontan circulation, a palliative surgical procedure for complex congenital heart disease. The research, involving 334 adults, found that elevated scores on the FibroSURE test, APRI, FIB-4, and MELD-XI were all independently associated with a substantially increased hazard of death or heart transplant. For instance, a FibroSURE score above the cirrhosis threshold (>0.74) was linked to a more than threefold increased risk. This work provides a crucial translational bridge, suggesting that routine, simple blood tests could help stratify long-term risk and guide the timing of advanced interventions in this vulnerable pediatric and adult congenital heart disease population.
Why it might matter to you: For pediatric cardiologists and congenital heart disease specialists, this study offers a practical, evidence-based tool for long-term surveillance. Integrating these readily available biomarkers into routine follow-up protocols could enhance risk prediction for late Fontan failure, informing decisions about referral for transplant evaluation or intensification of medical therapy. It directly addresses the critical need for better prognostic markers in the growing population of adults surviving with congenital heart disease, moving management beyond anatomy and function to include systemic organ health.
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