{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T19:14:55Z","timestamp":1787598895642,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,5,13]],"date-time":"2016-05-13T00:00:00Z","timestamp":1463097600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aortic root dilation in tetralogy of Fallot (TOF) is a long\u2010term clinical problem, because a severely dilated aorta can lead to aortic regurgitation, dissection, or rupture, which can be fatal, necessitating surgical intervention. The details of the mechanism of aortic root dilation, however, are unclear. We have shown that aortic stiffness is increased in patients with repaired TOF, and may mirror the histological abnormality of elastic fiber disruption and matrix expansion. This aortic stiffness is related closely to the aortic dilation, indicating that aortic stiffness may be a predictor of outcome of aortic dilation. Furthermore, the aortic volume overload is a very important determinant of aortic diameter in TOF patients before corrective surgery. In addition, a chromosomal abnormality and the transforming growth factor\u2010\u03b2 signaling pathway, a major contributor to aortic dilation in Marfan syndrome, also affect this mechanism. In this way, aortic dilation in TOF patients is suggested to be a multifactorial disorder. The aim of this review was therefore to clarify the mechanism of aortic dilation in TOF, focusing on recent research findings. Studies linking histopathology, mechanical properties, molecular\/cellular physiology, and clinical manifestations of aortic dilation facilitate appropriate treatment intervention and improvement of long\u2010term prognosis of TOF.<\/jats:p>","DOI":"10.1111\/ped.12932","type":"journal-article","created":{"date-parts":[[2016,1,26]],"date-time":"2016-01-26T08:35:01Z","timestamp":1453797301000},"page":"323-330","source":"Crossref","is-referenced-by-count":30,"title":["Mechanism of aortic root dilation and cardiovascular function in tetralogy of Fallot"],"prefix":"10.1111","volume":"58","author":[{"given":"Mitsuru","family":"Seki","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"},{"name":"Department of Pediatrics Gunma University School of Medicine  Maebashi Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiko","family":"Kuwata","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Kurishima","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"},{"name":"Department of Pediatric Cardiology Tokyo Women's Medical University  Shinjuku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"},{"name":"Johns Hopkins Medical Institute  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Inuzuka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Tokyo Hospital  Bunkyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Asahikawa Medical University  Asahikawa Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Saiki","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"},{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Iwamoto","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Ishido","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Masutani","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Senzaki","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Saitama Medical Center, Saitama Medical University  Kawagoe Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.3.393"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80188-3"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.03.026"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.05.037"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/S0022-5223(19)42200-9","article-title":"Total repair of tetralogy of Fallot and replacement of aortic valve with Starr\u2010Edwards prosthesis. 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