{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:49:52Z","timestamp":1786978192864,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T00:00:00Z","timestamp":1634256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2022,6]]},"abstract":"\n Background<\/jats:title>\n Adolescents and adults with native Ebstein's anomaly (EA) are at the benign part of the Ebstein spectrum, having survived infancy without surgery. In this population, surgical indication and timing remain objects of controversy and depend, among other factors, on exercise capacity.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To better understand the pathophysiology of exercise adaptation in native EA.<\/jats:p>\n <\/jats:sec>\n \n Study Type<\/jats:title>\n Retrospective.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n Ten patients with unoperated EA (age range 18\u201361\u2009years) and 13 healthy subjects as controls.<\/jats:p>\n <\/jats:sec>\n \n Field Strength\/Sequence<\/jats:title>\n Balanced steady\u2010state free precession cine and phase contrast flow sequences at 1.5\u2009T.<\/jats:p>\n <\/jats:sec>\n \n Assessment<\/jats:title>\n We measured volumes and flows at rest and during submaximal exercise. Hemodynamic parameters including stroke volume (SV), cardiac index (CI), ejection fraction (EF), and tricuspid regurgitation (TR) were calculated.<\/jats:p>\n <\/jats:sec>\n \n Statistical Tests<\/jats:title>\n \n We used nonparametric Mann\u2013Whitney\n U<\/jats:italic>\n \u2010test and Wilcoxon signed\u2010rank test. A\n P<\/jats:italic>\n \u2010value of <0.05 was considered statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Rest CI and SV were significantly higher in controls; rest heart rate (HR) was similar in the two groups (median 71\u2009bpm by patients and 65\u2009bpm by controls,\n P<\/jats:italic>\n \u00a0=\u00a00.448). During exercise, CI increased significantly in both groups: from 2.40 to 3.35\u2009L\/min\/m\n 2<\/jats:sup>\n in the patient group and from 3.60 to 4.20\u2009L\/min\/m\n 2<\/jats:sup>\n in controls; HR increased significantly in both groups. SV increased significantly in the patient group, whereas it remained stable in controls (\n P<\/jats:italic>\n \u00a0=\u00a00.5284). Patients' median TR decreased significantly: median 42% at rest and 30% during exercise; concomitantly, left ventricular (LV) preload increased significantly (+3% indexed LV end\u2010diastolic volume) as did LVEF (median 59% at rest vs. 65% during exercise).\n <\/jats:p>\n <\/jats:sec>\n \n Data Conclusion<\/jats:title>\n During submaximal exercise, patients with mild to moderate EA improved their cardiovascular system's total efficiency by increasing CI; this was obtained by an increase in HR and by the recruitment of volume, as shown by an increased LV end\u2010diastolic volume and SV, with simultaneous decrease in TR. This was different from healthy subjects in which CI increased only due to HR increase.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3<\/jats:p>\n <\/jats:sec>\n \n Technical Efficacy Stage<\/jats:title>\n 3<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jmri.27945","type":"journal-article","created":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T21:41:48Z","timestamp":1634506908000},"page":"1843-1850","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Improved Tricuspid Valve Function, Preload Recruitment and Ventricular Efficiency During Submaximal Exercise in Patients with Unoperated Ebstein's Anomaly: An\n MRI<\/scp>\n Study"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9005-2856","authenticated-orcid":false,"given":"Irene","family":"Ferrari","sequence":"first","affiliation":[{"name":"Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerejda","family":"Shehu","sequence":"additional","affiliation":[{"name":"Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Nagdyman","sequence":"additional","affiliation":[{"name":"Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Martinoff","sequence":"additional","affiliation":[{"name":"Radiology German Heart Center Munich Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[{"name":"Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Stern","sequence":"additional","affiliation":[{"name":"Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Meierhofer","sequence":"additional","affiliation":[{"name":"Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich Technical University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"issue":"3","key":"e_1_2_10_2_1","first-page":"174","article-title":"Morphologic spectrum of Ebstein's anomaly of the heart: A review","volume":"54","author":"Anderson KR","year":"1979","journal-title":"Mayo Clin 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