{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:46:44Z","timestamp":1787496404931,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2006,12,5]],"date-time":"2006-12-05T00:00:00Z","timestamp":1165276800000},"content-version":"vor","delay-in-days":825,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2004,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    : Increase in the gradient in congenital pulmonary valvular stenosis during follow\u2010up is a subject of controversy and could determine the need for treatment in pediatric patients.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Hypothesis<\/jats:italic>\n                    : It is postulated that a gradient &lt; 50 mmHg shows a stable or decreasing tendency at follow\u2010up for congenital pulmonary valvular stenosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods<\/jats:italic>\n                    : Thirty\u2010five patients with pulmonary stenosis, isolated and not treated, were followed for 7 years (interquartilic rank 5.7 years) at 1.5\u2010year intervals. Clinical and complementary tests (electrocardiogram, x\u2010ray, Doppler echocardiogram) were undertaken. The gradient was measured by Doppler and by using the clinical formula derived from the New England Study (Ellison). The changes observed from the initial to the final consultation were analyzed by means of the Student's\n                    <jats:italic>t<\/jats:italic>\n                    \u2010test, paired Wilcoxon, and Pearson correlation coefficient.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    : No significant changes were noted on symptoms or physical examination. Signs of cardiac enlargement diminished on both ECG (R wave in V1, p &lt; 0.0001) and x\u2010ray (car\u2010diothoracic ratio, p &lt; 0.0007), with a decreasing gradient trend during the follow\u2010up period (p &lt; 0.026) as well.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    : The gradient trend confirms the stable nature of mild pulmonary stenosis. In our study, we found that patients aged &gt; 6 months, whose gradients were below 40 mmHg at the time of diagnosis, remained stable and required no treatment. Furthermore, the follow\u2010up control and clinical management of these patients may then be performed at intervals of 2 years or more.\n                  <\/jats:p>","DOI":"10.1002\/clc.4960270910","type":"journal-article","created":{"date-parts":[[2007,6,28]],"date-time":"2007-06-28T01:16:20Z","timestamp":1182993380000},"page":"519-522","source":"Crossref","is-referenced-by-count":10,"title":["Does mild pulmonary stenosis progress during childhood? a study of its natural course"],"prefix":"10.1002","volume":"27","author":[{"given":"Julio","family":"Ardura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Andres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,12,5]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"969","article-title":"Valvuloplastie percutan\u00e9e des st\u00e9noses pulmonaires cong\u00e9nitales de l'adulte apr\u00e9s 50 ans","volume":"83","author":"Boutaud P","year":"1990","journal-title":"Arch Mal Coeur Vaiss"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.37.8.808"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(90)90090-S"},{"key":"e_1_2_1_5_2","first-page":"I\u201014","article-title":"Indirect assessment of severity in pulmonary stenosis","volume":"56","author":"Ellison RC","year":"1977","journal-title":"Circulation"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.66.3.238"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(86)90104-3"},{"key":"e_1_2_1_8_2","first-page":"I\u201028","article-title":"Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis","volume":"87","author":"Hayes CJ","year":"1993","journal-title":"Circulation"},{"key":"e_1_2_1_9_2","first-page":"283","article-title":"Doppler en las cardiopat\u00edas con obstrucci\u00f3n derecha e izquierda","volume":"34","author":"Izquierdo M","year":"1991","journal-title":"An Esp Pediatr"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197212072872301"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1980.tb07332.x"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(75)90319-1"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(65)90048-2"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000169634"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.5.2479"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.30.4.554"},{"key":"e_1_2_1_17_2","first-page":"I\u201038","article-title":"Clinical course in pulmonary stenosis","volume":"56","author":"Nugent EW","year":"1977","journal-title":"Circulation"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)62557-X"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)36840-7"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)00759-X"},{"key":"e_1_2_1_21_2","first-page":"37","article-title":"Natural history of valvular pulmonary stenosis in children below the age of two years. Long\u2010term follow\u2010up with serial heart catheterizations","volume":"8","author":"Wennevold A","year":"1978","journal-title":"Eur J Cardiol"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.4960270910","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.4960270910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T09:43:56Z","timestamp":1700214236000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.4960270910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,9]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2004,9]]}},"alternative-id":["10.1002\/clc.4960270910"],"URL":"https:\/\/doi.org\/10.1002\/clc.4960270910","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,9]]}}}