{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T10:38:05Z","timestamp":1793702285171,"version":"4.5.1"},"reference-count":30,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,1,4]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Residual sequelae after surgical repair of tetralogy of Fallot (rTOF) affect clinical outcome. We investigated the prognostic impact of right ventricular (RV) dyssynchrony in adults with rTOF years after the surgical repair.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients from the Swiss Adult Congenital HEart disease Registry were included. NT-proBNP levels, echocardiography, exercise testing and MRI data were collected. An offline strain analysis to quantify RV-ventricular and interventricular dyssynchrony was performed. The standard deviation of the time-to-peak shortening (TTP) of six RV segments defined the RV Dyssynchrony Index (RVDI). Maximal difference of TTP between RV and left ventricular segments defined the interventricular shortening delay (IVSD). Predictors of a composite adverse event (arrhythmias, hospitalisation for heart failure and death) were identified by multivariate Cox regression analysis. Their median values were used to create a risk score.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Out of 285 included patients (mean age 34\u00b114 years), 33 patients (12%) experienced an adverse event during a mean follow-up of 48\u00b121 months. No correlation was found between RVDI, IVSD and clinical events. NT-proBNP, right atrial area and peak heart rate were independent predictors of outcomes. After 4 years-follow-up, no adverse events occurred in patients at low risk (score=0 points), while an adverse event occurred in 62% of patients at high risk (score=3 points, p&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In our cohort of adults with rTOF, surrogates of RV dyssynchrony did not correlate with outcomes. A multimodality approach was effective in predicting the risk for adverse events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002583","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:25:20Z","timestamp":1705623920000},"page":"e002583","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic value of right ventricular dyssynchrony in adults with repaired tetralogy of Fallot"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6770-0173","authenticated-orcid":false,"given":"Andrea","family":"Papa","sequence":"first","affiliation":[{"name":"Center for Congenital Heart Disease, Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland"},{"name":"University Heart Center, University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"Nussbaumer","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease, Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Goulouti","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease, Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Schwitz","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease, Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Wustmann","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Centre Munich, Technical University Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Tobler","sequence":"additional","affiliation":[{"name":"University Heart Center, University Hospital Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Greutmann","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Schwerzmann","sequence":"additional","affiliation":[{"name":"Center for Congenital Heart Disease, Department of Cardiology, Inselspital, University of Bern, Bern, 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