{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:55:39Z","timestamp":1775073339723,"version":"3.50.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The present study was conducted to investigate the decrease in left ventricular stroke volume index (LVSVI) that is caused by pulmonary regurgitation-induced right heart dysfunction and its clinical implications before and after pulmonary valve replacement (PVR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between January 2010 and December 2019, 30 adults who underwent surgical PVR for chronic pulmonary regurgitation with right ventricular dilation late after tetralogy of Fallot (TOF) repair were included. All patients were evaluated using cardiac magnetic resonance before PVR. The median interval from TOF repair to PVR was 29 [25th, 75th percentile: 25, 37] years. The median pulmonary regurgitation fraction and right ventricular end-diastolic volume index were 56 [48, 66] % and 203 [187, 239] ml\/m2. Twenty-three patients (76.7%) were re-evaluated 1\u2009year after PVR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Before PVR, the median LVSVI was 40 [35, 46] ml\/beat\/m2. A lower LVSVI was associated with a longer interval from TOF repair to PVR (r = \u22120.40, P\u2009=\u20090.029) and a lower right ventricular ejection fraction (r\u2009=\u20090.52, P\u2009=\u20090.004). A lower LVSVI was not associated with a higher right ventricular end-diastolic volume index. LVSVI remained unchanged after PVR. The patients were subdivided into Normal-stroke volume index (SVI) and Subnormal-SVI groups using the preoperative LVSVI cut-off value of 35\u2009mL\/beat\/m2. Compared with the Normal-SVI group, the Subnormal-SVI group had a higher incidence of ablation therapy before PVR (4.7 vs 2.3 patient-years, P\u2009=\u20090.044). After PVR, LVSVI in the Subnormal-SVI group was still lower (40 [34, 42] vs 44 [42, 47] ml\/beat\/m2, P\u2009=\u20090.038) despite the right ventricular end-diastolic volume index normalization. There was no difference in the clinical event incidence between the 2 groups during the follow-up period. Brain natriuretic peptide level in the Subnormal-SVI group was higher within 3\u2009years after PVR (P\u2009=\u20090.046).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Reduced left ventricular stroke volume did not fully recover after PVR. PVR for patients with repaired TOF should be performed before the left ventricular stroke volume begins to decrease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab112","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T12:21:14Z","timestamp":1613391674000},"page":"526-533","source":"Crossref","is-referenced-by-count":5,"title":["The reduced left ventricular stroke volume does not fully recover after pulmonary valve replacement in patients with repaired tetralogy of Fallot"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1616-067X","authenticated-orcid":false,"given":"Takashi","family":"Yasukawa","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cadiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-3682","authenticated-orcid":false,"given":"Takaya","family":"Hoashi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cadiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cadiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Okuda","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cadiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Ohuchi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Kurosaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiovascular Surgery, National Cerebral and Cadiovascular Center, Suita, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,19]]},"reference":[{"key":"2021091118381834300_ezab112-B1","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1016\/j.amjcard.2015.07.043","article-title":"Risk factors for prosthetic pulmonary valve failure in patients with congenital heart disease","volume":"116","author":"Oliver","year":"2015","journal-title":"Am J Cardiol"},{"key":"2021091118381834300_ezab112-B2","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1161\/CIRCULATIONAHA.106.659664","article-title":"Preoperative thresholds for pulmonary valve replacement in patients with corrected tetralogy of Fallot using cardiovascular magnetic resonance","volume":"116","author":"Oosterhof","year":"2007","journal-title":"Circulation"},{"key":"2021091118381834300_ezab112-B3","doi-asserted-by":"crossref","first-page":"S182","DOI":"10.1161\/CIRCULATIONAHA.107.756825","article-title":"Biventricular response after pulmonary valve replacement for right ventricular outflow tract dysfunction: is age a predictor of outcome?","volume":"118","author":"Frigiola","year":"2008","journal-title":"Circulation"},{"key":"2021091118381834300_ezab112-B4","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/j.jacc.2012.03.077","article-title":"Outcomes of pulmonary valve replacement in 170 patients with chronic pulmonary regurgitation after relief of right ventricular outflow tract obstruction: implications for optimal timing of pulmonary valve replacement","volume":"60","author":"Lee","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2021091118381834300_ezab112-B5","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1161\/CIRCULATIONAHA.108.775221","article-title":"Pulmonary valve replacement in tetralogy of Fallot. 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