{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:14:12Z","timestamp":1777958052475,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Eccentricity Index is an echocardiographic predictor of disease severity in children with pulmonary arterial hypertension (PAH). Its utility after atrioventricular septal defect (AVSD) repair remains unclear due to surgical manipulation of the ventricular septum. We evaluated end\u2010systolic (EIs) and maximal (EIm) as predictors of hemodynamics post\u2010AVSD repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cohort 1 was 89 children, 5\u201324 months after complete AVSD repair, and similarly aged controls. Subgroups of those with (+) and without (\u2212) PAH were based on other echocardiographic markers of PAH. Cohort 2 was 20 children who underwent cardiac catheterization after AVSD repair. EIs and EIm were calculated as the ratio of the left ventricular diameter parallel to the septum divided by the perpendicular diameter measured at end systole and maximal post\u2010systolic flattening, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In Cohort 1, EIs and EIm in AVSD cases were greater than in controls. Both were highest in PAH(+) patients, followed by PAH(\u2212), followed by controls. EIs predicted echo\u2010estimated right ventricular systolic pressure, while EIm did not. In Cohort 2, EIs and EIm predicted RVSP \u2265 35\u00a0mmHg, while only EIs predicted PVRi \u22653 Wu*m\n                      <jats:sup>2<\/jats:sup>\n                      . An EIs threshold of 1.28 optimally predicted elevated RVSP (AUC 0.761) and PVRi (AUC 0.779).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After AVSD repair, EIs and EIm are elevated compared to those of otherwise healthy children. However, significant elevation (Eis &gt; 1.28) may still be useful to differentiate those with and without PAH. A multiparametric approach may be needed for borderline EIs (1.09\u20131.28). These findings support EI as a non\u2010invasive screening tool to identify PAH in children after AVSD repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70451","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T10:56:17Z","timestamp":1775645777000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Eccentricity Index Is Associated With Pulmonary Arterial Hypertension in Children After Repair of Complete Atrioventricular Septal Defects"],"prefix":"10.1111","volume":"43","author":[{"given":"Charles T.","family":"Simpkin","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Colorado Medical Campus  Aurora Colorado USA"},{"name":"Heart Institute Children's Hospital Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa","family":"DeLima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Medical Campus  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgan","family":"MacBeth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Medical Campus  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dale A.","family":"Burkett","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Medical Campus  Aurora Colorado USA"},{"name":"Heart Institute Children's Hospital Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Dunbar","family":"Ivy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Medical Campus  Aurora Colorado USA"},{"name":"Heart Institute Children's Hospital Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin S.","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Medical Campus  Aurora Colorado USA"},{"name":"Heart Institute Children's Hospital Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2020.11.005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.03337\u20102020"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.03.033"},{"key":"e_1_2_11_5_1","volume-title":"Moss & Adams\u2019 Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult","author":"Shaddy R. 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