{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:46:14Z","timestamp":1792107974122,"version":"4.4.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital diaphragmatic hernia (CDH) remains a major cause of neonatal mortality and morbidity. Early systolic left ventricular (LV) dysfunction is well described in CDH, while diastolic impairment remains unexplored. This study aimed to investigate the feasibility LV diastolic function assessment and to evaluate its relationship with clinical severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Observational, single-centre cohort study. In newborns with CDH, gestational age &gt;32 weeks, echocardiographic assessment of diastolic function evaluation was performed at &lt; 24\u2009hours of age. Data were compared to normative values and correlated to clinical status and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-two infants were included, gestational age 38.0 (32.1\u201340.3) weeks. Diastolic function in CDH vs. normative controls were: LV mitral E wave 47 (\u2009\u00b1\u200914) vs. 56 (\u2009\u00b1\u20098) cm\/sec,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; LV tissue Doppler early diastolic velocity (e\u2019) 4.1 (\u2009\u00b1\u20091.3) vs. 6.7 (\u2009\u00b1\u20091.4) cm\/sec,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; left atrial reservoir strain (LASr) 21.3 (\u2009\u00b1\u20098.7) vs 33.3 (\u2009\u00b1\u20094.4)%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; and E:e\u2019 ratio 12 (\u2009\u00b1\u20094.2) vs. 33.3 (\u2009\u00b1\u20094.4),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001. LASr correlated with pCO\n                      <jats:sub>2<\/jats:sub>\n                      (r\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and FiO\n                      <jats:sub>2<\/jats:sub>\n                      (r\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); was lower in non-survivors (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027) and infants requiring invasive ventilation at 14 days (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diastolic impairment is frequent in the first 24\u2009hours of life in CDH and may contribute to disease severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Early cardiac ultrasound assessment is crucial in management of congenital diaphragmatic hernia (CDH). Our current investigation addresses the unanswered question of left ventricular (LV) diastolic function and its contribution to pulmonary hypertension and disease severity in CDH.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>We investigated the feasibility of assessing left ventricular (LV) diastolic function in infants with CDH in the first 24\u2009hours of life. Using a panel of echocardiographic measures, including the innovative technique of left atrial strain analysis, assessment of diastolic function was feasible in this cohort.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Reduced LV diastolic echocardiographic parameters were observed in &gt;70% of the CDH cohort, compared to normative reference data.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>LV diastolic function parameters correlated with echocardiographic estimates of pulmonary artery pressure and measures of global LV systolic function, indicating potential mechanistic interactions and re-consideration of established therapies.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            In CDH cases, early LV diastolic function correlated with clinical parameters and outcomes. Specifically, left atrial strain (LASr) was lower in non-survivors and patients who remained ventilated at 14 days of age. LASr was inversely correlated with maximum arterial PaCO\n                            <jats:sub>2<\/jats:sub>\n                            and maximum inspired fraction of oxygen (FiO\n                            <jats:sub>2<\/jats:sub>\n                            ) values in the first 24\u2009hours of life, and positively correlated with maximum post-ductal oxygen saturation of haemoglobin (SpO\n                            <jats:sub>2<\/jats:sub>\n                            ).\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04560-6","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T05:04:31Z","timestamp":1762923871000},"page":"1158-1165","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Early left ventricular diastolic function and disease severity in congenital diaphragmatic hernia"],"prefix":"10.1038","volume":"100","author":[{"given":"Giulia Vanina","family":"Cantone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijit","family":"Bhattacharya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Healy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Levinkopf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Claudia","family":"Massolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flaminia","family":"Pugnaloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Vento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"Heuchan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Kipfmueller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"4560_CR1","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1038\/s41572-022-00362-w","volume":"8","author":"A Zani","year":"2022","unstructured":"Zani, A. et al. Congenital diaphragmatic hernia. Nat. Rev. Dis. Prim. 8, 37 (2022).","journal-title":"Nat. Rev. Dis. Prim."},{"key":"4560_CR2","doi-asserted-by":"publisher","first-page":"890422","DOI":"10.3389\/fped.2022.890422","volume":"10","author":"N Patel","year":"2022","unstructured":"Patel, N., Massolo, A. C., Kraemer, U. S. & Kipfmueller, F. The heart in congenital diaphragmatic hernia: Knowns, unknowns, and future priorities. Front. Pediatr. 10, 890422 (2022).","journal-title":"Front. Pediatr."},{"key":"4560_CR3","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.1164\/rccm.201904-0731OC","volume":"200","author":"N Patel","year":"2019","unstructured":"Patel, N. et al. Ventricular Dysfunction Is a Critical Determinant of Mortality in Congenital Diaphragmatic Hernia. Am. J. Respir. Crit. Care Med. 200, 1522\u20131530 (2019).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"4560_CR4","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.jjcc.2019.03.002","volume":"73","author":"RA Nishimura","year":"2019","unstructured":"Nishimura, R. A. & Borlaug, B. A. Diastology for the clinician. J. Cardiol. 73, 445\u2013452 (2019).","journal-title":"J. Cardiol."},{"key":"4560_CR5","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1097\/PCC.0b013e31829b1e7a","volume":"15","author":"F Moenkemeyer","year":"2014","unstructured":"Moenkemeyer, F. & Patel, N. Right Ventricular Diastolic Function Measured by Tissue Doppler Imaging Predicts Early Outcome in Congenital Diaphragmatic Hernia. Pediatr. Crit. Care Med. 15, 49\u201355 (2014).","journal-title":"Pediatr. Crit. Care Med."},{"key":"4560_CR6","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","volume":"29","author":"SF Nagueh","year":"2016","unstructured":"Nagueh, S. F. et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr. 29, 277\u2013314 (2016).","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"4560_CR7","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1093\/ehjci\/jeac123","volume":"23","author":"BA Popescu","year":"2022","unstructured":"Popescu, B. A., Beladan, C. C., Nagueh, S. F. & Smiseth, O. A. How to assess left ventricular filling pressures by echocardiography in clinical practice. Eur. Heart J. - Cardiovasc. Imaging 23, 1127\u20131129 (2022).","journal-title":"Eur. Heart J. - Cardiovasc. Imaging"},{"key":"4560_CR8","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1097\/HCO.0000000000000963","volume":"37","author":"OKA Hassan","year":"2022","unstructured":"Hassan, O. K. A. & Higgins, A. R. The role of multimodality imaging in patients with heart failure with reduced and preserved ejection fraction. Curr. Opin. Cardiol. 37, 285\u2013293 (2022).","journal-title":"Curr. Opin. Cardiol."},{"key":"4560_CR9","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.echo.2023.11.016","volume":"37","author":"PJ McNamara","year":"2024","unstructured":"McNamara, P. J. et al. Guidelines and Recommendations for Targeted Neonatal Echocardiography and Cardiac Point-of-Care Ultrasound in the Neonatal Intensive Care Unit: An Update from the American Society of Echocardiography. J. Am. Soc. Echocardiogr. 37, 171\u2013215 (2024).","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"4560_CR10","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1159\/000215585","volume":"96","author":"N Patel","year":"2009","unstructured":"Patel, N., Mills, J. F. & Cheung, M. M. H. Assessment of Right Ventricular Function Using Tissue Doppler Imaging in Infants with Pulmonary Hypertension. Neonatology 96, 193\u2013199 (2009).","journal-title":"Neonatology"},{"key":"4560_CR11","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s44156-024-00051-2","volume":"11","author":"S Robinson","year":"2024","unstructured":"Robinson, S. et al. The assessment of left ventricular diastolic function: guidance and recommendations from the British Society of Echocardiography. Echo Res. Pract. 11, 16 (2024).","journal-title":"Echo Res. Pract."},{"key":"4560_CR12","doi-asserted-by":"publisher","first-page":"350","DOI":"10.3390\/diagnostics12020350","volume":"12","author":"B Ficial","year":"2022","unstructured":"Ficial, B. et al. Feasibility, Reproducibility and Reference Ranges of Left Atrial Strain in Preterm and Term Neonates in the First 48 h of Life. Diagnostics 12, 350 (2022).","journal-title":"Diagnostics"},{"key":"4560_CR13","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1007\/s10554-023-02816-y","volume":"39","author":"MR Silva","year":"2023","unstructured":"Silva, M. R., Sampaio, F., Braga, J., Ribeiro, J. & Fontes-Carvalho, R. Left atrial strain evaluation to assess left ventricle diastolic dysfunction and heart failure with preserved ejection fraction: a guide to clinical practice: Left atrial strain and diastolic function. Int. J. Cardiovasc. Imaging 39, 1083\u20131096 (2023).","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"4560_CR14","doi-asserted-by":"publisher","first-page":"e34","DOI":"10.1093\/ehjci\/jeab154","volume":"23","author":"OA Smiseth","year":"2022","unstructured":"Smiseth, O. A. et al. Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging. Eur. Heart J. - Cardiovasc. Imaging 23, e34\u2013e61 (2022).","journal-title":"Eur. Heart J. - Cardiovasc. Imaging"},{"key":"4560_CR15","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1007\/s10554-020-02114-x","volume":"37","author":"A Ferkh","year":"2021","unstructured":"Ferkh, A. et al. Inter-vendor comparison of left atrial strain using layer specific strain analysis. Int. J. Cardiovasc. Imaging 37, 1279\u20131288 (2021).","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"4560_CR16","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1093\/ehjci\/jey042","volume":"19","author":"LP Badano","year":"2018","unstructured":"Badano, L. P. et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI\/ASE\/Industry Task Force to standardize deformation imaging. Eur. Heart J. - Cardiovasc. Imaging 19, 591\u2013600 (2018).","journal-title":"Eur. Heart J. - Cardiovasc. Imaging"},{"key":"4560_CR17","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. et al. Early Postnatal Ventricular Dysfunction Is Associated with Disease Severity in Patients with Congenital Diaphragmatic Hernia. J. Pediatr. 203, 400\u2013407.e1 (2018).","journal-title":"J. Pediatr."},{"key":"4560_CR18","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-59441-5","volume":"14","author":"E Petoello","year":"2024","unstructured":"Petoello, E. et al. Global longitudinal strain is an informative index of left ventricular performance in neonates receiving intensive care. Sci. Rep. 14, 8881 (2024).","journal-title":"Sci. Rep."},{"key":"4560_CR19","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1055\/s-0033-1357757","volume":"25","author":"A Bialkowski","year":"2013","unstructured":"Bialkowski, A., Moenkemeyer, F. & Patel, N. Intravenous Sildenafil in the Management of Pulmonary Hypertension Associated with Congenital Diaphragmatic Hernia. Eur. J. Pediatr. Surg. 25, 171\u2013176 (2013).","journal-title":"Eur. J. Pediatr. Surg."},{"key":"4560_CR20","doi-asserted-by":"publisher","first-page":"1709","DOI":"10.1007\/s00246-019-02208-x","volume":"40","author":"K De Waal","year":"2019","unstructured":"De Waal, K., Costley, N., Phad, N. & Crendal, E. Left Ventricular Diastolic Dysfunction and Diastolic Heart Failure in Preterm Infants. Pediatr. Cardiol. 40, 1709\u20131715 (2019).","journal-title":"Pediatr. Cardiol."},{"key":"4560_CR21","doi-asserted-by":"publisher","first-page":"F304","DOI":"10.1136\/adc.2009.175109","volume":"97","author":"RJS Negrine","year":"2012","unstructured":"Negrine, R. J. S., Chikermane, A., Wright, J. G. C. & Ewer, A. K. Assessment of myocardial function in neonates using tissue Doppler imaging. Arch. Dis. Child. - Fetal Neonatal Ed. 97, F304\u2013F306 (2012).","journal-title":"Arch. Dis. Child. - Fetal Neonatal Ed."},{"key":"4560_CR22","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.jpeds.2016.11.003","volume":"182","author":"A Jain","year":"2017","unstructured":"Jain, A. et al. Left Ventricular Function in Healthy Term Neonates During the Transitional Period. J. Pediatr. 182, 197\u2013203.e2 (2017).","journal-title":"J. Pediatr."},{"key":"4560_CR23","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1038\/s41390-018-0079-8","volume":"84","author":"E Nestaas","year":"2018","unstructured":"Nestaas, E., Schubert, U., de Boode, W. P., El-Khuffash, A. & European Special Interest Group \u2018Neonatologist Performed Echocardiography\u2019 (NPE) Tissue Doppler velocity imaging and event timings in neonates: a guide to image acquisition, measurement, interpretation, and reference values. Pediatr. Res. 84, 18\u201329 (2018).","journal-title":"Pediatr. Res."},{"key":"4560_CR24","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/s41390-018-0080-2","volume":"84","author":"on behalf of the European Special Interest Group \u2018Neonatologist Performed Echocardiography\u2019 (NPE)","year":"2018","unstructured":"on behalf of the European Special Interest Group \u2018Neonatologist Performed Echocardiography\u2019 (NPE) et al. Deformation imaging and rotational mechanics in neonates: a guide to image acquisition, measurement, interpretation, and reference values. Pediatr. Res. 84, 30\u201345 (2018).","journal-title":"Pediatr. Res."},{"key":"4560_CR25","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1016\/j.echo.2014.08.018","volume":"27","author":"A Jain","year":"2014","unstructured":"Jain, A. et al. A Comprehensive Echocardiographic Protocol for Assessing Neonatal Right Ventricular Dimensions and Function in the Transitional Period: Normative Data and Z Scores. J. Am. Soc. Echocardiogr. 27, 1293\u20131304 (2014).","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"4560_CR26","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.1111\/echo.14140","volume":"35","author":"K De Waal","year":"2018","unstructured":"De Waal, K., Phad, N. & Boyle, A. Left atrium function and deformation in very preterm infants with and without volume load. Echocardiography 35, 1818\u20131826 (2018).","journal-title":"Echocardiography"},{"key":"4560_CR27","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1111\/echo.15686","volume":"40","author":"K De Waal","year":"2023","unstructured":"De Waal, K., Phad, N. & Crendal, E. Echocardiography algorithms to assess high left atrial pressure and grade diastolic function in preterm infants. Echocardiography 40, 1099\u20131106 (2023).","journal-title":"Echocardiography"},{"key":"4560_CR28","doi-asserted-by":"publisher","first-page":"1404350","DOI":"10.3389\/fped.2024.1404350","volume":"12","author":"K\u00d6 Tyd\u00e9n","year":"2024","unstructured":"Tyd\u00e9n, K. \u00d6., Mesas Burgos, C., Jonsson, B. & Nordenstam, F. Left atrial strain in neonates with congenital diaphragmatic hernia and length of stay in pediatric intensive care unit. Front. Pediatr. 12, 1404350 (2024).","journal-title":"Front. Pediatr."},{"key":"4560_CR29","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s12574-017-0364-2","volume":"16","author":"OA Smiseth","year":"2018","unstructured":"Smiseth, O. A. Evaluation of left ventricular diastolic function: state of the art after 35 years with Doppler assessment. J. Echocardiogr. 16, 55\u201364 (2018).","journal-title":"J. Echocardiogr."},{"key":"4560_CR30","doi-asserted-by":"publisher","DOI":"10.1590\/1414-431x2023e12521","volume":"56","author":"ALA Nour","year":"2023","unstructured":"Nour, A. L. A. et al. The myocardial capillary network is altered in congenital diaphragmatic hernia in the fetal rabbit model. Braz. J. Med. Biol. Res. 56, e12521 (2023).","journal-title":"Braz. J. Med. Biol. Res."},{"key":"4560_CR31","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.yjmcc.2021.04.001","volume":"157","author":"S Zhaorigetu","year":"2021","unstructured":"Zhaorigetu, S., Gupta, V. S., Jin, D. & Harting, M. T. Cardiac energy metabolism may play a fundamental role in congenital diaphragmatic hernia-associated ventricular dysfunction. J. Mol. Cell. Cardiol. 157, 14\u201316 (2021).","journal-title":"J. Mol. Cell. Cardiol."},{"key":"4560_CR32","doi-asserted-by":"publisher","first-page":"114061","DOI":"10.1016\/j.jpeds.2024.114061","volume":"271","author":"MV Fraga","year":"2024","unstructured":"Fraga, M. V. et al. Congenital Diaphragmatic Hernia Patients with Left Heart Hypoplasia and Left Ventricular Dysfunction Have Highest Odds of Mortality. J. Pediatr. 271, 114061 (2024).","journal-title":"J. Pediatr."},{"key":"4560_CR33","doi-asserted-by":"publisher","first-page":"151438","DOI":"10.1016\/j.sempedsurg.2024.151438","volume":"33","author":"G Altit","year":"2024","unstructured":"Altit, G., Lapointe, A., Kipfmueller, F. & Patel, N. Cardiac function in congenital diaphragmatic hernia. Semin. Pediatr. Surg. 33, 151438 (2024).","journal-title":"Semin. Pediatr. Surg."},{"key":"4560_CR34","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jpeds.2017.08.060","volume":"191","author":"G Altit","year":"2017","unstructured":"Altit, G., Bhombal, S., Van Meurs, K. & Tacy, T. A. Ventricular Performance is Associated with Need for Extracorporeal Membrane Oxygenation in Newborns with Congenital Diaphragmatic Hernia. J. Pediatr. 191, 28\u201334.e1 (2017).","journal-title":"J. Pediatr."},{"key":"4560_CR35","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1159\/000499347","volume":"116","author":"AC Massolo","year":"2019","unstructured":"Massolo, A. C. et al. Ventricular Dysfunction, Interdependence, and Mechanical Dispersion in Newborn Infants with Congenital Diaphragmatic Hernia. Neonatology 116, 68\u201375 (2019).","journal-title":"Neonatology"},{"key":"4560_CR36","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.hfc.2019.06.005","volume":"15","author":"MJ Sorrentino","year":"2019","unstructured":"Sorrentino, M. J. The Evolution from Hypertension to Heart Failure. Heart Fail. Clin. 15, 447\u2013453 (2019).","journal-title":"Heart Fail. Clin."},{"key":"4560_CR37","doi-asserted-by":"publisher","first-page":"151437","DOI":"10.1016\/j.sempedsurg.2024.151437","volume":"33","author":"KI Holden","year":"2024","unstructured":"Holden, K. I., Rintoul, N. E., McNamara, P. J. & Harting, M. T. Congenital diaphragmatic hernia-associated pulmonary hypertension. Semin. Pediatr. Surg. 33, 151437 (2024).","journal-title":"Semin. Pediatr. Surg."},{"key":"4560_CR38","doi-asserted-by":"publisher","first-page":"101383","DOI":"10.1016\/j.siny.2022.101383","volume":"27","author":"S Bhombal","year":"2022","unstructured":"Bhombal, S. & Patel, N. Diagnosis & management of pulmonary hypertension in congenital diaphragmatic hernia. Semin. Fetal Neonatal Med. 27, 101383 (2022).","journal-title":"Semin. Fetal Neonatal Med."},{"key":"4560_CR39","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1038\/s41390-023-02491-8","volume":"93","author":"CY Noh","year":"2023","unstructured":"Noh, C. Y. et al. Early nitric oxide is not associated with improved outcomes in congenital diaphragmatic hernia. Pediatr. Res. 93, 1899\u20131906 (2023).","journal-title":"Pediatr. Res."},{"key":"4560_CR40","doi-asserted-by":"publisher","first-page":"2780","DOI":"10.1161\/01.CIR.90.6.2780","volume":"90","author":"E Loh","year":"1994","unstructured":"Loh, E., Stamler, J. S., Hare, J. M., Loscalzo, J. & Colucci, W. S. Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. Circulation 90, 2780\u20132785 (1994).","journal-title":"Circulation"},{"key":"4560_CR41","doi-asserted-by":"publisher","first-page":"e000790","DOI":"10.1136\/wjps-2024-000790","volume":"7","author":"A Surak","year":"2024","unstructured":"Surak, A., Mahgoub, L. & Ting, J. Y. Hemodynamic management of congenital diaphragmatic hernia: the role of targeted neonatal echocardiography. World J. Pediatr. Surg. 7, e000790 (2024).","journal-title":"World J. Pediatr. Surg."},{"key":"4560_CR42","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1007\/s00383-014-3574-y","volume":"30","author":"N Inamura","year":"2014","unstructured":"Inamura, N. et al. Efficacy of the circulatory management of an antenatally diagnosed congenital diaphragmatic hernia: outcomes of the proposed strategy. Pediatr. Surg. Int. 30, 889\u2013894 (2014).","journal-title":"Pediatr. Surg. Int."},{"key":"4560_CR43","doi-asserted-by":"publisher","first-page":"113490","DOI":"10.1016\/j.jpeds.2023.113490","volume":"260","author":"LS Le","year":"2023","unstructured":"Le, L. S., Kinsella, J. P., Gien, J. & Frank, B. S. Failure to Normalize Biventricular Function Is Associated with Extracorporeal Membrane Oxygenation Use in Neonates with Congenital Diaphragmatic Hernia. J. Pediatr. 260, 113490 (2023).","journal-title":"J. Pediatr."},{"key":"4560_CR44","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1186\/s12872-023-03194-y","volume":"23","author":"B Mashayekhi","year":"2023","unstructured":"Mashayekhi, B., Mohseni-Badalabadi, R., Hosseinsabet, A. & Ahmadian, T. Correlation between Heart rate recovery and Left Atrial phasic functions evaluated by 2D speckle-tracking Echocardiography after Acute Myocardial infarction. BMC Cardiovasc. Disord. 23, 164 (2023).","journal-title":"BMC Cardiovasc. Disord."}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04560-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04560-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04560-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:57:31Z","timestamp":1792105051000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-025-04560-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":44,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["4560"],"URL":"https:\/\/doi.org\/10.1038\/s41390-025-04560-6","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"value":"0031-3998","type":"print"},{"value":"1530-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"assertion":[{"value":"1 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Research Ethics and Institutional Information Governance Approval were obtained for retrospective analysis of all clinical data without requirement for individual consent (IRAS ID 318553).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Ethics"}}]}}