{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T13:42:52Z","timestamp":1776433372320,"version":"3.51.2"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"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>Background<\/jats:title>\n                    <jats:p>Right ventricular (RV) dysfunction is a key determinant of long\u2010term morbidity in patients following surgical repair of tetralogy of Fallot (TOF). Identifying practical biomarkers for early detection of right\u2010sided heart failure remains clinically relevant, particularly in pediatric populations with subclinical disease. The albumin\u2013bilirubin (ALBI) score, a simple and objective marker of hepatic function, has emerged as a potential surrogate of systemic congestion in heart failure. This study aimed to evaluate whether the ALBI score reflects right ventricular dysfunction in pediatric patients after TOF repair and to examine its relationship with N\u2010terminal pro\u2013brain natriuretic peptide (NT\u2010proBNP) and echocardiographic indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, 46 pediatric patients (&lt;8 years) with repaired TOF and 46 age\u2010matched healthy controls were enrolled. Clinical data, laboratory parameters including ALBI score and NT\u2010proBNP, and comprehensive echocardiographic measurements were obtained. Associations between ALBI score and demographic, biochemical, and imaging variables were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median postoperative time since surgical repair was 99 months. Compared with controls, repaired TOF patients exhibited significantly elevated NT\u2010proBNP levels (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), increased RV and right atrial diameters (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001 and\n                      <jats:italic>p<\/jats:italic>\n                      = 0.017), and reduced tricuspid annular plane systolic excursion (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), indicating subclinical RV dysfunction. However, the ALBI score did not differ between groups (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.848) and showed no significant association with functional class, anti\u2010congestive therapy, NT\u2010proBNP levels, or echocardiographic parameters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite structural and biomarker evidence of subclinical RV involvement, the ALBI score did not reflect early right ventricular dysfunction in this relatively stable pediatric TOF cohort. Prospective studies including patients with more advanced hemodynamic impairment are warranted to clarify whether ALBI may have prognostic or monitoring value in later stages of right ventricular dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70462","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:03:42Z","timestamp":1775829822000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Albumin\u2013Bilirubin Score and Subclinical Right Ventricular Dysfunction After Repair of Tetralogy of Fallot"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-2718","authenticated-orcid":false,"given":"Erhan","family":"S\u00f6nmez","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Faculty of Medicine Erciyes University  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6zge Pamuk\u00e7u","family":"Akay","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Faculty of Medicine Marmara University Pendik Training and Research Hospital  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunus Emre","family":"Kum","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology Aksaray University Training and Research Hospital  Aksaray Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sedat","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Faculty of Medicine Erciyes University  Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Funda","family":"\u0130pekten","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, Faculty of Medicine Adiyaman University  Adiyaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Baykan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Faculty of Medicine Erciyes University  Kayseri 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