4D flow cardiovascular magnetic resonance derived energetics in the Fontan circulation correlate with exercise capacity and CMR-derived liver fibrosis/congestion

In Fontan circulation, higher liver cT1 (fibrosis/congestion) correlated with impaired exercise capacity and adverse 4D blood flow measured with CMR. Findings link hepatic injury to hemodynamic inefficiency, supporting combined 4D flow CMR and LiverMultiScan for noninvasive risk assessment.