{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:59:33Z","timestamp":1785419973945,"version":"3.56.0"},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951126111615_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      Right ventricular outflow tract reconstruction frequently leads to long-term pulmonary failure and ventricular dilation. This study aims to investigate the dynamics of matrix metalloproteinase-2, matrix metalloproteinase-9, and procollagen type-1\n                      <jats:italic>N<\/jats:italic>\n                      -terminal propeptide in predicting postoperative remodelling and to evaluate the \u201cprotective\u201d potential of restrictive right ventricular physiology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126111615_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This prospective comparative cohort study included 20 patients undergoing right ventricular outflow tract reconstruction (Research Group) and 20 patients undergoing atrial or ventricular septal defect repair via transatrial approach (Control Group). Biomarker levels were measured using ELISA at preoperative, early postoperative (24\u201348 hours), and 6-month intervals. Right ventricular geometry was assessed with cross-sectional snapshots at 6 months and 10 years. Right ventricular dilation was defined as right ventricular end-diastolic volume index &gt; 150 ml\/m\n                      <jats:sup>2<\/jats:sup>\n                      or diameter\n                      <jats:italic>z<\/jats:italic>\n                      -score &gt; 2, while preserved geometry was defined as right ventricular end-diastolic volume index &lt; 100 ml\/m\n                      <jats:sup>2<\/jats:sup>\n                      or diameter\n                      <jats:italic>z<\/jats:italic>\n                      -score &lt; 1.5.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126111615_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Early postoperative biomarker increases were similar (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.310) but differed significantly at 6 months. In the study group, matrix metalloproteinase-2 (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and procollagen type-1\n                      <jats:italic>N<\/jats:italic>\n                      -terminal propeptide (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001) levels remained significantly elevated, independent of pulmonary regurgitation severity (\n                      <jats:italic>p<\/jats:italic>\n                      &gt; 0.05). Ten years later, restrictive physiology was observed in 10 patients (50%), representing a progression compared to the 8 patients identified at 6 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126111615_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      Persistent elevation of matrix metalloproteinase-2 and procollagen type-1\n                      <jats:italic>N<\/jats:italic>\n                      -terminal propeptide reflects an active \u201cremodeling\u201d process. Restrictive physiology is associated with the \u201cBiological Banding\u201d mechanism. By increasing myocardial stiffness, this adaptive process is linked to protecting the right ventricle from irreversible dilation under chronic volume overload.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951126111615","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T09:56:04Z","timestamp":1773050164000},"page":"452-458","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Dynamics of matrix metalloproteinases and procollagen type-1\n                    <i>N<\/i>\n                    -terminal propeptide following right ventricular outflow tract reconstruction: the protective mechanism of restrictive physiology"],"prefix":"10.1017","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9382-5179","authenticated-orcid":false,"given":"Mehmet","family":"Aslan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01zxaph45","id-type":"ROR","asserted-by":"publisher"}],"name":"Ministry of Health Alanya Alaaddin Keykubat University Alanya Education and Rese"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3623-6130","authenticated-orcid":false,"given":"Onur","family":"Benli","sequence":"additional","affiliation":[{"name":"Cukurova Universitesi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugur","family":"Gocen","sequence":"additional","affiliation":[{"name":"Ortadogu Private Health Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2527-2665","authenticated-orcid":false,"given":"Atakan","family":"Atalay","sequence":"additional","affiliation":[{"name":"Ankara City Hospital Cardiovascular Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Y\u00fcksel","sequence":"additional","affiliation":[{"name":"Ortadogu Private Health Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Poyrazoglu","sequence":"additional","affiliation":[{"name":"Private Medline Adana Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Sah","family":"Topcuoglu","sequence":"additional","affiliation":[{"name":"Cukurova University Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafize","family":"Yaliniz","sequence":"additional","affiliation":[{"name":"Cukurova Universitesi Tip 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in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951126111615","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:08:28Z","timestamp":1776085708000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951126111615\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["S1047951126111615"],"URL":"https:\/\/doi.org\/10.1017\/s1047951126111615","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"\u00a9 The Author(s), 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