{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T01:29:56Z","timestamp":1787880596659,"version":"build-2784847793"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T00:00:00Z","timestamp":1570060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Medical Foundation Fellowship awarded"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The optimal timing for pulmonary valve replacement in asymptomatic patients with repaired Tetralogy of Fallot (rTOF) and pulmonary regurgitation remains uncertain but is often guided by increases in right ventricular (RV) end-diastolic volume. As cardiopulmonary exercise testing (CPET) performance is a strong prognostic indicator, we assessed which cardiovascular magnetic resonance (CMR) parameters correlate with reductions in exercise capacity to potentially improve identification of high-risk patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>In all, 163 patients with rTOF (mean age 24.5\u2009\u00b1\u200910.2\u2009years) who had previously undergone CMR and standardized CPET protocols were included. The indexed right and left ventricular end-diastolic volumes (RVEDVi, LVEDVi), right and left ventricular ejection fractions (RVEF, LVEF), indexed RV stroke volume (RVSVi), and pulmonary regurgitant fraction (PRF) were quantified by CMR and correlated with CPET-determined peak oxygen consumption (VO2) or peak work. On univariable analysis, there was no significant correlation between RVEDVi and PRF with peak VO2 or peak work (% Jones-predicted). In contrast, RVEF and RVSVi had significant correlations with both peak VO2 and peak work that remained significant on multivariable analysis. For a previously established prognostic peak VO2 threshold of &amp;lt;27\u2009mL\/kg\/min, receiver-operating characteristic curve analysis demonstrated a Harrell\u2019s c of 0.70 for RVEF (95% confidence interval 0.61\u20130.79) with a sensitivity of 88% for RVEF &amp;lt;40%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In rTOF, CMR indices of RV systolic function are better predictors of CPET performance than RV size. An RVEF &amp;lt;40% may be useful to identify prognostically significant reductions in exercise capacity in patients with varying degrees of RV dilatation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jez245","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T19:25:58Z","timestamp":1568229958000},"page":"906-913","source":"Crossref","is-referenced-by-count":29,"title":["Right ventricular systolic dysfunction but not dilatation correlates with prognostically significant reductions in exercise capacity in repaired Tetralogy of Fallot"],"prefix":"10.1093","volume":"21","author":[{"given":"Imran","family":"Rashid","sequence":"first","affiliation":[{"name":"Cardiovascular Magnetic Resonance Sydney, 100 Carillon Ave, Newtown, NSW 2042, Australia"},{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London, Westminster Bridge Rd, Lambeth SE17EH, UK"},{"name":"Department of Cardiology, Guy\u2019s and St Thomas\u2019 Hospital, Westminster Bridge Rd, Lambeth SE17EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Mahmood","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London, Westminster Bridge Rd, Lambeth SE17EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tevfik F","family":"Ismail","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering and Imaging Sciences, King\u2019s College London, Westminster Bridge Rd, Lambeth SE17EH, UK"},{"name":"Department of Cardiology, Guy\u2019s and St Thomas\u2019 Hospital, Westminster Bridge Rd, Lambeth SE17EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamus","family":"O\u2019Meagher","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby","family":"Kutty","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center, Children's Hospital and Medical Center, 42nd and Emile, Omaha, NE 68198, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Celermajer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, Sydney, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Puranik","sequence":"additional","affiliation":[{"name":"Cardiovascular Magnetic Resonance Sydney, 100 Carillon Ave, Newtown, NSW 2042, Australia"},{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, 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