{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T13:34:26Z","timestamp":1784900066808,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Congenital shunt location is related to Eisenmenger syndrome (ES) survival. Moreover, right ventricular (RV) remodeling is associated with poor survival in pulmonary hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate RV remodeling using comprehensive magnetic resonance imaging (MRI) techniques and identify its relationship with prognosis in ES subgroups classified by shunt location.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Fifty\u2010four adults with ES (16 with pre\u2010tricuspid shunt and 38 with post\u2010tricuspid shunt).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3.<jats:styled-content style=\"fixed-case\">0\u2009T<\/jats:styled-content>\/cine <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> with balanced steady\u2010state free precession sequence, late gadolinium enhancement with inversion recovery segmented gradient echo sequence and phase\u2010sensitive reconstruction, and <jats:styled-content style=\"fixed-case\">T1<\/jats:styled-content> mapping with modified <jats:styled-content style=\"fixed-case\">Look\u2010Locker<\/jats:styled-content> inversion recovery sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Demographics, clinical characteristics, hemodynamics, RV remodeling features (morphology, systolic function, RV\u2013pulmonary artery (PA) coupling and myocardial fibrosis), and prognosis were compared between ES subgroups. The adverse endpoint was all\u2010cause mortality or readmission for heart failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>The independent samples <jats:italic>t<\/jats:italic>\u2010test, Fisher's exact test or Chi\u2010squared test, and the Kaplan\u2013Meier method were used. <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 was considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to patients with post\u2010tricuspid shunt, patients with pre\u2010tricuspid shunt were significantly older and had higher N\u2010terminal pro\u2010B\u2010type natriuretic peptide concentrations and poorer exercise tolerance. Pre\u2010tricuspid shunt showed significantly larger RV dimensions (end\u2010diastolic volume index: 185.81\u2009\u00b1\u200937.49 vs. 98.20\u2009\u00b1\u200936.26\u2009mL\/m<jats:sup>2<\/jats:sup>), worse RV ejection fraction (23.54%\u2009\u00b1\u200912.35% vs. 40.82%\u2009\u00b1\u200910.77%), and RV\u2013PA decoupling (0.35\u2009\u00b1\u20090.31 vs. 0.72\u2009\u00b1\u20090.29). Biventricular myocardial fibrosis was significantly more severe in pre\u2010tricuspid shunt than post\u2010tricuspid shunt (extracellular volume, left ventricle: 35.85%\u2009\u00b1\u20092.58% vs. 29.10%\u2009\u00b1\u20095.20%; RV free wall: 30.93%\u2009\u00b1\u20095.65% vs. 26.75%\u2009\u00b1\u20095.15%). In addition, pre\u2010tricuspid shunt demonstrated a significantly increased risk of adverse endpoint (hazard ratio: 2.938, 95% confidence interval: 1.204\u20137.172).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>ES with pre\u2010tricuspid shunt might be a unique subtype with worse clinically decompensated RV remodeling and poor prognosis.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold>: 2<\/jats:p><jats:p><jats:bold>Technical Efficacy Stage<\/jats:bold>: 5<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.27791","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T11:30:00Z","timestamp":1624275000000},"page":"1478-1488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Diverse Right Ventricular Remodeling Evaluated by <scp>MRI<\/scp> and Prognosis in Eisenmenger Syndrome With Different Shunt 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