{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T09:50:19Z","timestamp":1773309019201,"version":"3.50.1"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>In patients with right ventricular (RV) outflow tract stenosis and pulmonary regurgitation (PR), percutaneous pulmonary valve implantation (PPVI) aims to preserve RV and left ventricular (LV) integrity and function. Our study aimed to assess acute changes in biventricular intrinsic myocardial function occurring with PPVI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Twenty patients with RV outflow tract dysfunction (mean\u00b11 SD; age, 23.0\u00b110.9 years; mean peak echocardiographic RV outflow tract gradient, 64\u00b125 mm\u2009Hg) underwent PPVI with biventricular assessment of pressure-volume loops using the conductance catheter technique during the same cardiac catheterization. Load-independent parameters of ventricular contractility (ventricular elastance) and ventricular compliance function, as well as pulmonary\/systemic arterial elastance and ventriculoarterial coupling, were assessed before and directly after PPVI. Cardiac magnetic resonance for quantification of biventricular volumes, function, and PR was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      After PPVI, both RV ventricular elastance (median [interquartile range], 0.26 [0.16\u20130.83] to 0.19 [0.13\u20130.42] mm\u2009Hg\/mL per m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.029) and pulmonary systemic arterial elastance (0.32\u00b10.20 to 0.25\u00b10.19 mm\u2009Hg\/mL per m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) decreased significantly, while right ventriculoarterial coupling (1.14\u00b10.61 to 1.10\u00b10.59;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.76) did not change statistically significant. LV ventricular elastance (1.31\u00b10.93 to 1.23\u00b10.72 mm\u2009Hg\/mL per m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.68) and left ventriculoarterial coupling (0.75 [0.51\u20131.23] to 0.82 [0.53\u20131.10];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.98) were not affected by PPVI although systemic arterial elastance increased significantly (0.83\u00b10.26 to 0.90\u00b10.34 mm\u2009Hg\/mL per m\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.032). Both RV (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.37) and LV (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.20) compliance showed no significant change after PPVI. Patients with relevant PR (\u226525%; n=10) had lower RV ventricular elastance (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.043) before and higher LV compliance (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.010) after PPVI compared with patients with minor PR (&lt;25%; n=10), whereas ventriculoarterial coupling was similar between the 2 groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Acute reduction of RV overload by PPVI is accompanied by an instantaneous decline in RV contractility with persistent and inefficient ventriculoarterial coupling. The LV adequately adapts to an increase in pre- and post-load with nonsignificant changes in LV intrinsic function and ventriculoarterial coupling. The relevance of these response patterns on long-term biventricular remodeling requires further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.013235","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:00:08Z","timestamp":1766484008000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Real-Time Biventricular Pressure-Volume Loops During Percutaneous Pulmonary Valve Implantation in Patients With RVOT Dysfunction"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3939-6025","authenticated-orcid":true,"given":"Heiner","family":"Latus","sequence":"first","affiliation":[{"name":"Clinic for Congenital Heart Disease and Pediatric Cardiology (H.L., V.S., C.M., D.T., A.E., P.E., S.G.), German Heart Centre Munich."},{"name":"Department of Pediatric Cardiology, University Children\u2019s Hospital, University of T\u00fcbingen, Germany (H.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verena","family":"Schindler","sequence":"additional","affiliation":[{"name":"Clinic for Congenital Heart Disease and Pediatric Cardiology (H.L., V.S., C.M., D.T., A.E., P.E., S.G.), German Heart Centre Munich."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1971-4375","authenticated-orcid":true,"given":"Julie","family":"Cleuziou","sequence":"additional","affiliation":[{"name":"Department of Congenital and Paediatric Heart Surgery (J.C.), German Heart Centre Munich."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8897-7200","authenticated-orcid":true,"given":"Markus","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, University Children\u2019s Hospital, University of Cologne, Germany (M.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Jux","sequence":"additional","affiliation":[{"name":"Clinic for Pediatric Cardiology, Intensive Care Medicine and Congenital Heart Disease, Giessen, Germany (C.J.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1367-3410","authenticated-orcid":true,"given":"Christian","family":"Meierhofer","sequence":"additional","affiliation":[{"name":"Clinic for Congenital Heart Disease and Pediatric Cardiology (H.L., V.S., C.M., D.T., A.E., P.E., S.G.), German Heart Centre Munich."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1723-1254","authenticated-orcid":true,"given":"Daniel","family":"Tanase","sequence":"additional","affiliation":[{"name":"Clinic for Congenital Heart Disease and Pediatric Cardiology (H.L., V.S., C.M., D.T., A.E., P.E., S.G.), German Heart Centre Munich."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Eicken","sequence":"additional","affiliation":[{"name":"Clinic for Congenital Heart Disease and Pediatric Cardiology (H.L., V.S., C.M., D.T., A.E., P.E., S.G.), German Heart Centre Munich."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-1190","authenticated-orcid":true,"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[{"name":"Clinic for Congenital Heart Disease and Pediatric Cardiology (H.L., V.S., C.M., D.T., A.E., P.E., S.G.), German Heart Centre Munich."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6239-8160","authenticated-orcid":true,"given":"Stanimir","family":"Georgiev","sequence":"additional","affiliation":[{"name":"Clinic for Congenital Heart Disease and Pediatric Cardiology (H.L., V.S., C.M., D.T., A.E., P.E., S.G.), German Heart Centre 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