{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:17Z","timestamp":1790586017897,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Pulmonary regurgitation (PR) after right ventricular outflow tract (RVOT) reconstruction is a major driver of right ventricular (RV) remodeling. Cardiac magnetic resonance (CMR) is the reference standard for quantifying PR but is not routinely feasible in many pediatric follow\u2010up settings. We evaluated whether an echocardiographic early\u2010diastolic RV\u2013pulmonary artery (PA) pressure gradient (Echo\u2010EaDPG), derived from early\u2010diastolic peak PR velocity (\u0394P = 4v\n                      <jats:sup>2<\/jats:sup>\n                      ), can serve as a practical complementary hemodynamic marker to guide CMR assessment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients with repaired tetralogy of Fallot or related conditions who underwent echocardiography, CMR, and cardiac catheterization within a 6\u2010month interval of each other after RVOT reconstruction. Echo\u2010EaDPG was compared with CMR\u2010derived PR fraction (CMR\u2010PRF) and catheter\u2010measured early\u2010diastolic RV\u2013PA pressure gradient (Cathe\u2010EaDPG). Clinically significant PR was operationally defined as CMR\u2010PRF \u2265 25%. Correlation, multivariable analyses, receiver operating characteristic (ROC) analysis, and bootstrap internal validation were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty patients were included. Echo\u2010EaDPG correlated with CMR\u2010PRF (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.65,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and Cathe\u2010EaDPG (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.55,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and was independently associated with CMR\u2010PRF \u2265 25% among tested echocardiographic indices. Echo\u2010EaDPG demonstrated good discrimination for identifying CMR\u2010PRF \u2265 25% on ROC analysis (AUC = 0.90), with bootstrap\u2010supported robustness. Interobserver agreement for Echo\u2010EaDPG was excellent (ICC = 0.96, 95% CI 0.82\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Echo\u2010EaDPG is a simple Doppler\u2010derived parameter associated with CMR\u2010quantified PR and invasive early\u2010diastolic RV\u2013PA gradients after RVOT reconstruction. As an adjunct to integrated echocardiographic assessment, Echo\u2010EaDPG may help identify patients who warrant CMR for quantitative PR evaluation, particularly when routine CMR is difficult to obtain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70614","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T23:54:02Z","timestamp":1788566042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early\u2010Diastolic Right Ventricle\u2013Pulmonary Artery Pressure Gradient by Doppler Echocardiography to Guide Cardiac Magnetic Resonance Assessment of Pulmonary Regurgitation after Right Ventricular Outflow Tract Reconstruction"],"prefix":"10.1111","volume":"43","author":[{"given":"Junpei","family":"Kawamura","sequence":"first","affiliation":[{"name":"Department of Pediatrics Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsubasa","family":"Shimozono","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Nakae","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Takumi","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yoshiura","sequence":"additional","affiliation":[{"name":"Department of Radiology Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02714-8"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi581"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.124.039006","article-title":"Outcome Prediction After Tetralogy of Fallot Repair: A Prospective Clinical and Cardiovascular Magnetic Resonance Study","volume":"15","author":"Wald R. 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