{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:36:53Z","timestamp":1773031013171,"version":"3.50.1"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951120000888_as1\" sec-type=\"other\"><jats:title>Introduction:<\/jats:title><jats:p>Exercise stress echocardiography and layer-specific strains are emerging as important tools for cardiac assessment. This study was aimed to evaluate layer-specific strains and torsion parameters during exercise in order to investigate the characteristics of cardiac dysfunction in patients with repaired tetralogy of Fallot and to detect subclinical left ventricular dysfunction.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951120000888_as2\" sec-type=\"other\"><jats:title>Materials and Methods:<\/jats:title><jats:p>Thirteen patients with repaired tetralogy of Fallot (median age, 17.3 [interquartile range, 14.5\u201322.9] years; 6 males) and 13 controls (median age, 28.5 [interquartile range, 27.6\u201331.6] years; 13 males) underwent echocardiography at rest and during supine exercise. Layer-specific longitudinal strain and circumferential strain of three myocardial layers (endocardium, midmyocardium, and epicardium), torsion, and untwisting rate were measured using two-dimensional speckle-tracking echocardiography.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951120000888_as3\" sec-type=\"other\"><jats:title>Results:<\/jats:title><jats:p>Peak endocardial papillary circumferential strain (\u221221.1 \u00b1 2.6% vs. \u221225.8 \u00b1 3.8%, <jats:italic>p<\/jats:italic> = 0.007), midmyocardial apical circumferential strain (\u221211.1 \u00b1 4.0% vs. \u221215.6 \u00b1 3.2%, <jats:italic>p<\/jats:italic> = 0.001), epicardial apical circumferential strain (\u221211.1 \u00b1 4.0% vs. \u221215.6 \u00b1 3.2%, <jats:italic>p<\/jats:italic> = 0.021), and torsion (8.9 \u00b1 6.0 vs. 14.9 \u00b1 4.8 degree, <jats:italic>p<\/jats:italic> = 0.021) were significantly lower in the repaired tetralogy of Fallot group than in the control group during exercise, though no significant difference was found between patients and controls at rest.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951120000888_as4\" sec-type=\"other\"><jats:title>Conclusions:<\/jats:title><jats:p>Analysis of layer-specific strains and torsion parameters during exercise could detect subclinical left ventricular dysfunction in patients with repaired tetralogy of Fallot, which might reflect potential myocardial damage, at a stage where these parameters have normal values at rest. This finding provides new insight into the mechanisms of cardiac dysfunction in patients with repaired tetralogy of Fallot.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951120000888","type":"journal-article","created":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T09:41:58Z","timestamp":1588585318000},"page":"710-716","source":"Crossref","is-referenced-by-count":2,"title":["Exercise echocardiography demonstrates potential myocardial damage in patients with repaired tetralogy of Fallot using layer-specific strain 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