{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:57:31Z","timestamp":1787684251629,"version":"build-2784847793"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac dysfunction is increasingly recognized as an important feature in congenital diaphragmatic hernia (CDH); however, detailed longitudinal data describing perioperative biventricular adaptation remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study included 49 infants who underwent CDH surgery between 2017 and 2024. Three-dimensional echocardiography was used to measure left ventricular (LV) and right ventricular (RV) end-diastolic volume (LVEDV and RVEDV, respectively), ejection fraction (EF), and cardiac output at 1\u20133 days of age, preoperatively, and at &lt;18\u2009h and 24\u201372\u2009h postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 1\u20133 days of age, LV parameters showed minimal changes. RVEF increased (37.5% to 45.5%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), with reductions in RV end-systolic volume and improved ventricular\u2013arterial coupling. The LVEDV\/RVEDV ratio increased from 0.65\u2009\u00b1\u20090.18 (1 day of age) to 0.74\u2009\u00b1\u20090.24 (preoperatively) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001). Postoperatively (24\u201372\u2009h), indexed ventricular and stroke volumes increased compared with preoperative measurements; LVEDV increased from 1.32\u2009mL\/kg to 1.51\u2009mL\/kg (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008) and RVEDV from 1.82\u2009mL\/kg to 2.07\u2009mL\/kg (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperatively, RV systolic performance and RV\u2013pulmonary arterial coupling improved, possibly reflecting the effects of management and\/or physiological adaptation. After repair, biventricular end-diastolic and stroke volumes increased, consistent with enhanced postoperative ventricular filling.<\/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>This study is the first to serially evaluate biventricular volumes and function from birth through the perioperative period in infants with congenital diaphragmatic hernia (CDH) using three-dimensional echocardiography.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Preoperatively, right ventricular\u2013pulmonary arterial coupling improved over time.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Surgical repair was associated with increases in biventricular end-diastolic volumes and stroke volumes in the early postoperative phase, consistent with enhanced ventricular filling.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This study provides novel physiological insights into the distinct adaptive mechanisms of both ventricles, which may have valuable implications for perioperative management.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-026-04970-0","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T08:26:35Z","timestamp":1777019195000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Perioperative biventricular function in congenital diaphragmatic hernia: a three-dimensional echocardiographic study"],"prefix":"10.1038","author":[{"given":"Katsuaki","family":"Toyoshima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Katsumata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Shimokaze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Kishigami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasagu","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirosato","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Ohmura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Shibasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoyoshi","family":"Kawataki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Mochizuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiko","family":"Kitagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naka","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Masutani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"4970_CR1","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.siny.2014.09.004","volume":"19","author":"MT Harting","year":"2014","unstructured":"Harting, M. 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