{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:07:38Z","timestamp":1780085258611,"version":"3.54.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000862","name":"Doris Duke Charitable Foundation","doi-asserted-by":"publisher","award":["2021262"],"award-info":[{"award-number":["2021262"]}],"id":[{"id":"10.13039\/100000862","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23 HL150337"],"award-info":[{"award-number":["K23 HL150337"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Fetoscopic endoluminal tracheal occlusion (FETO) induces lung growth and may improve survival in congenital diaphragmatic hernia (CDH) but the effect on post-natal right (RV) and left (LV) ventricular size and cardiac function is unknown. Quantitative measures of heart size and function including tricuspid annular plane systolic excursion Z-score (TAPSEZ), RV fractional area change (RVFAC), RV global longitudinal and free wall strain (RVGLS, RVFWS), RV\/LV ratio, LV eccentricity index (LVEI), and LV M-mode diastolic and systolic Z-scores (LVIDDZ, LVIDSZ) were compared between FETO and control patients on first post-natal echocardiogram, prior to and post CDH repair, and on last available echocardiogram using non-parametric Wilcoxon rank-sum test in a single-center, retrospective cohort study. Linear regression models evaluated change over time, adjusting for clustering and interaction of echocardiogram parameters with time. Thirty-two patients (10 FETO, 22 control) met inclusion criteria. At first echocardiogram, FETO patients demonstrated lower RV\/LV ratio and LVEI (p\u2009=\u20090.01 for both) indicating less RV dilation and less ventricular septal displacement, respectively. LV hypoplasia was less severe in FETO patients (p\u2009=\u20090.01 for both LVIDDZ and LVIDSZ) initially. After repair, FETO patients demonstrated better RV systolic function compared to control patients by FAC (p\u2009&lt;\u20090.01), RVGLS (p\u2009=\u20090.02), and RVFWS (p\u2009=\u20090.05). Over time, FETO patients demonstrated greater improvements in RV\/LV ratio and LVEI but smaller increases in LV dimensions compared to control patients. Improvements in RV function were similar between the groups. FETO patients demonstrate differences in cardiac size and function compared to control patients.<\/jats:p>","DOI":"10.1007\/s00246-024-03735-y","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T12:36:34Z","timestamp":1734093394000},"page":"132-140","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Echocardiographic Changes in Infants with Severe Congenital Diaphragmatic Hernia After Fetoscopic Endoluminal Tracheal Occlusion (FETO)"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2354-5447","authenticated-orcid":false,"given":"Catherine M.","family":"Avitabile","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Flohr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leny","family":"Mathew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devon","family":"Ash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana S.","family":"Gebb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie E.","family":"Rintoul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly L.","family":"Hedrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"3735_CR1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1053\/j.sempedsurg.2017.04.011","volume":"26","author":"D Ameis","year":"2017","unstructured":"Ameis D, Khoshgoo N, Keijzer R (2017) Abnormal lung development in congenital diaphragmatic hernia. Semin Pediatr Surg 26:123\u2013128","journal-title":"Semin Pediatr Surg"},{"key":"3735_CR2","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1097\/SLA.0000000000005113","volume":"277","author":"VS Gupta","year":"2023","unstructured":"Gupta VS, Harting MT, Lally PA et al (2023) Mortality in congenital diaphragmatic hernia: a multicenter registry study of over 5000 patients over 25 years. Ann Surg 277:520\u2013527","journal-title":"Ann Surg"},{"key":"3735_CR3","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1002\/uog.1711","volume":"24","author":"J Deprest","year":"2004","unstructured":"Deprest J et al (2004) Fetoscopic tracheal occlusion (FETO) for severe congenital diaphragmatic hernia: evolution of a technique and preliminary results. Ultrasound Obstet Gynecol 24:121\u20136","journal-title":"Ultrasound Obstet Gynecol"},{"key":"3735_CR4","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1002\/uog.6450","volume":"34","author":"JC Jani","year":"2009","unstructured":"Jani JC, Nicolaides KH, Gratac\u00f3s E et al (2009) Severe diaphragmatic hernia treated by fetal endoscopic tracheal occlusion. Ultrasound Obstet Gynecol 34:304\u2013310","journal-title":"Ultrasound Obstet Gynecol"},{"key":"3735_CR5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1056\/NEJMoa2027030","volume":"385","author":"JA Deprest","year":"2021","unstructured":"Deprest JA, Nicolaides KH, Benachi A et al (2021) Randomized trial of fetal surgery for severe left diaphragmatic hernia. N Engl J Med 385:107\u2013118","journal-title":"N Engl J Med"},{"key":"3735_CR6","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1164\/rccm.201904-0731OC","volume":"200","author":"N Patel","year":"2019","unstructured":"Patel N, Lally PA, Kipfmueller F et al (2019) Ventricular dysfunction is a critical determinant of mortality in congenital diaphragmatic hernia. Am J Respir Crit Care Med 200:1522\u20131530","journal-title":"Am J Respir Crit Care Med"},{"key":"3735_CR7","doi-asserted-by":"publisher","first-page":"e000878","DOI":"10.1161\/CIRCIMAGING.113.000878","volume":"8","author":"MJ Ploegstra","year":"2014","unstructured":"Ploegstra MJ, Roofthooft MT, Douwes JM et al (2014) Echocardiography in pediatric pulmonary arterial hypertension: early study on assessing disease severity and predicting outcome. Circ Cardiovasc Imaging 8:e000878","journal-title":"Circ Cardiovasc Imaging"},{"key":"3735_CR8","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1161\/CIR.0000000000000329","volume":"132","author":"SH Abman","year":"2015","unstructured":"Abman SH, Hansmann G, Archer SL et al (2015) Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society. Circulation 132:2037\u20132099","journal-title":"Circulation"},{"key":"3735_CR9","first-page":"765","volume-title":"Echocardiography in pediatric and congenital heart disease","author":"SD Colan","year":"2009","unstructured":"Colan SD (2009) Normal echocardiographic values for cardiovascular structures. In: Lai WW, Cohen MS, Geva T, Mertens L (eds) Echocardiography in pediatric and congenital heart disease. Wiley-Blackwell, West Sussex, pp 765\u2013785"},{"key":"3735_CR10","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.echo.2014.01.015","volume":"27","author":"PT Levy","year":"2014","unstructured":"Levy PT, Sanchez Mejia AA, Machefsky A et al (2014) Normal ranges of right ventricular systolic and diastolic strain measures in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 27:549\u2013560","journal-title":"J Am Soc Echocardiogr"},{"key":"3735_CR11","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/j.echo.2009.03.026","volume":"22","author":"M Koestenberger","year":"2009","unstructured":"Koestenberger M, Ravekes W, Everett AD et al (2009) Right ventricular function in infants, children and adolescents: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr 22:715\u2013719","journal-title":"J Am Soc Echocardiogr"},{"key":"3735_CR12","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1159\/000322006","volume":"100","author":"M Koestenberger","year":"2011","unstructured":"Koestenberger M, Nagel B, Ravekes W et al (2011) Systolic right ventricular function in preterm and term neonates: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 258 patients and calculation of Z-score values. Neonatology 100:85\u201392","journal-title":"Neonatology"},{"key":"3735_CR13","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1086\/685051","volume":"6","author":"M Koestenberger","year":"2016","unstructured":"Koestenberger M, Friedberg MK, Nestaas E et al (2016) Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction. Pulm Circ 6:15\u201329","journal-title":"Pulm Circ"},{"key":"3735_CR14","doi-asserted-by":"publisher","first-page":"e009825","DOI":"10.1161\/CIRCIMAGING.119.009825","volume":"13","author":"DA Burkett","year":"2020","unstructured":"Burkett DA, Patel SS, Mertens L et al (2020) Relationship between left ventricular geometry and invasive hemodynamics in pediatric pulmonary hypertension. Circ Cardiovasc Imaging 13:e009825. https:\/\/doi.org\/10.1161\/CIRCIMAGING.119.009825","journal-title":"Circ Cardiovasc Imaging"},{"issue":"2","key":"3735_CR15","doi-asserted-by":"publisher","first-page":"204589401875924","DOI":"10.1177\/2045894018759247","volume":"8","author":"RK Hopper","year":"2018","unstructured":"Hopper RK, Wang Y, DeMatteo V et al (2018) Right ventricular function mirrors clinical improvement with use of prostacyclin analogues in pediatric pulmonary hypertension. Pulm Circ 8(2):2045894018759247. https:\/\/doi.org\/10.1177\/2045894018759247","journal-title":"Pulm Circ"},{"key":"3735_CR16","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1016\/j.echo.2018.02.013","volume":"31","author":"MP DiLorenzo","year":"2018","unstructured":"DiLorenzo MP, Elci OU, Wang Y et al (2018) Longitudinal changes in right ventricular function in tetralogy of Fallot in the initial years after surgical repair. J Am Soc Echocardiogr 31:816\u2013821","journal-title":"J Am Soc Echocardiogr"},{"key":"3735_CR17","doi-asserted-by":"publisher","first-page":"e1055","DOI":"10.1097\/CCM.0000000000003358","volume":"46","author":"AS Himebauch","year":"2018","unstructured":"Himebauch AS, Yehya N, Wang Y et al (2018) Early right ventricular systolic dysfunction and pulmonary hypertension are associated with worse outcomes in pediatric acute respiratory distress syndrome. Crit Care Med 46:e1055\u2013e1062","journal-title":"Crit Care Med"},{"key":"3735_CR18","doi-asserted-by":"publisher","first-page":"e121","DOI":"10.1097\/PCC.0000000000002206","volume":"21","author":"AS Himebauch","year":"2020","unstructured":"Himebauch AS, Yehya N, Wang Y et al (2020) New or persistent right ventricular systolic dysfunction is associated with worse outcomes in pediatric acute respiratory distress syndrome. Pediatr Crit Care Med 21:e121\u2013e128","journal-title":"Pediatr Crit Care Med"},{"key":"3735_CR19","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1038\/s41372-022-01421-6","volume":"42","author":"CM Avitabile","year":"2022","unstructured":"Avitabile CM, Zhang X, Ampah SB et al (2022) Factors associated with discontinuation of pulmonary vasodilator therapy in children with bronchopulmonary dysplasia-associated pulmonary hypertension. J Perinatol 42:1246\u20131254","journal-title":"J Perinatol"},{"key":"3735_CR20","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.echo.2013.10.014","volume":"27","author":"PN Jone","year":"2014","unstructured":"Jone PN, Hinzman J, Wagner BD et al (2014) Right ventricular to left ventricular diameter ratio at end-systole in evaluating outcomes in children with pulmonary hypertension. J Am Soc Echocardiogr 27:172\u2013178","journal-title":"J Am Soc Echocardiogr"},{"key":"3735_CR21","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1513\/AnnalsATS.201910-767OC","volume":"17","author":"CM Avitabile","year":"2020","unstructured":"Avitabile CM, Wang Y, Zhang X et al (2020) Right ventricular strain, brain natriuretic peptide, and mortality in congenital diaphragmatic hernia. Ann Am Thorac Soc 17:1431\u20131439","journal-title":"Ann Am Thorac Soc"},{"key":"3735_CR22","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1016\/j.jpeds.2018.07.062","volume":"203","author":"N Patel","year":"2018","unstructured":"Patel N, Massolo AC, Paria A et al (2018) Early postnatal ventricular dysfunction is associated with disease severity in patients with congenital diaphragmatic hernia. J Pediatr 203:400\u2013407","journal-title":"J Pediatr"},{"key":"3735_CR23","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1007\/s00246-018-1850-7","volume":"39","author":"G Altit","year":"2018","unstructured":"Altit G, Bhombal S, Van Meurs K et al (2018) Diminished cardiac performance and left ventricular dimensions in neonates with congenital diaphragmatic hernia. Pediatr Cardiol 39:993\u20131000","journal-title":"Pediatr Cardiol"},{"key":"3735_CR24","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.jpeds.2018.02.040","volume":"197","author":"JP Kinsella","year":"2018","unstructured":"Kinsella JP, Steinhorn RH, Mullen MP et al (2018) The left ventricle in congenital diaphragmatic hernia: implications for the management of pulmonary hypertension. J Pediatr 197:17\u201322","journal-title":"J Pediatr"},{"key":"3735_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2022.11.028","author":"PD Maia","year":"2022","unstructured":"Maia PD, Gien J, Kinsella JP et al (2022) Hemodynamic characterization of neonates with congenital diaphragmatic hernia-associated pulmonary hypertension by cardiac catheterization. J Pediatr. https:\/\/doi.org\/10.1016\/j.jpeds.2022.11.028","journal-title":"J Pediatr"},{"key":"3735_CR26","doi-asserted-by":"publisher","first-page":"114061","DOI":"10.1016\/j.jpeds.2024.114061","volume":"1","author":"MV Fraga","year":"2024","unstructured":"Fraga MV, Hedrick HL, Rintoul NE et al (2024) Congenital diaphragmatic hernia patients with left heart hypoplasia and left ventricular dysfunction have highest odds of mortality. J Pediatr 1:114061. https:\/\/doi.org\/10.1016\/j.jpeds.2024.114061","journal-title":"J Pediatr"},{"key":"3735_CR27","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.jpeds.2007.11.006","volume":"152","author":"PM Mourani","year":"2008","unstructured":"Mourani PM, Ivy DD, Rosenberg AA et al (2008) Left ventricular diastolic dysfunction in bronchopulmonary dysplasia. J Pediatr 152:291\u2013293","journal-title":"J Pediatr"},{"key":"3735_CR28","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1001\/jamacardio.2020.1511","volume":"5","author":"KN Goss","year":"2020","unstructured":"Goss KN, Haraldsdottir K, Beshish AG et al (2020) Association between preterm birth and arrested cardiac growth in adolescents and young adults. JAMA Cardiol 5:910\u2013919","journal-title":"JAMA Cardiol"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-024-03735-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-024-03735-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-024-03735-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:43:01Z","timestamp":1769064181000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-024-03735-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,13]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["3735"],"URL":"https:\/\/doi.org\/10.1007\/s00246-024-03735-y","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4978354\/v1","asserted-by":"object"}]},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,13]]},"assertion":[{"value":"26 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}