{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:32:59Z","timestamp":1777383179862,"version":"3.51.4"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Hypoplastic left heart syndrome (HLHS) carries a high mortality. The prognostic value of echocardiographic variables at presentation and the importance of serial data are poorly explored.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>\n              We retrospectively analyzed longitudinal clinical and echocardiographic parameters of children with hypoplastic left heart syndrome. The primary outcome was time to death or transplant after stage-1 surgery, right censored at stage 3 surgery, accounting for sequential surgical procedures. Univariable and multivariable analysis identified risk factors for transplant or mortality. Time-dependent trends in echo parameters stratified by patient survival were explored using nonparametric methods. In total 67 children with hypoplastic left heart syndrome were included. The 10-week, 20-week, and 1-year survival proportions were 77.6% (66\u201386), 68.7% (56\u201378), and 54.1% (41\u201365), respectively. At presentation, multivariable analysis identified a thicker interventricular septum (hazard ratio [HR], 1.64;\n              <jats:italic>P<\/jats:italic>\n              =0.007) to be associated with increased risk for transplant\/death, whereas higher tricuspid valve annular planar systolic excursion z score (HR, 0.61;\n              <jats:italic>P<\/jats:italic>\n              =0.003) was associated with reduced risk of mortality\/transplant. After stage-1, higher body surface area-indexed right ventricular end-systolic area (HR, 1.52;\n              <jats:italic>P<\/jats:italic>\n              =0.02), lower fractional area change (HR, 1.18;\n              <jats:italic>P<\/jats:italic>\n              =0.01), and qualitatively decreased right ventricular function (HR, 2.55;\n              <jats:italic>P<\/jats:italic>\n              =0.08) were associated with increased risk of transplant-free mortality, censored at stage 3. Higher body surface area-indexed right ventricular end-diastolic area (HR, 0.76;\n              <jats:italic>P<\/jats:italic>\n              =0.04) and better tricuspid valve annular planar systolic excursion z score (HR, 0.49;\n              <jats:italic>P<\/jats:italic>\n              =0.01) were associated with lower mortality\/transplant. During follow-up, right ventricular dilation, dysfunction, and tricuspid regurgitation improved in transplant-free survivors and worsened in those transplanted or who died.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Conventional echocardiographic parameters at presentation and during follow-up are potential markers for transplant-free survival in children with hypoplastic left heart syndrome.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.117.006983","type":"journal-article","created":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T09:15:11Z","timestamp":1531732511000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Prognostic Value of Serial Echocardiography in Hypoplastic Left Heart Syndrome"],"prefix":"10.1161","volume":"11","author":[{"given":"Jae Sung","family":"Son","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea (J.S.S.)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"James","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children and University of Toronto, ON, Canada (A.J., C.-P.S.F., L.M., B.W.M., C.M., M.K.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Po Steve","family":"Fan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children and University of Toronto, ON, Canada (A.J., C.-P.S.F., L.M., B.W.M., C.M., M.K.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc","family":"Mertens","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children and University of Toronto, ON, Canada (A.J., C.-P.S.F., L.M., B.W.M., C.M., M.K.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian W.","family":"McCrindle","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children and University of Toronto, ON, Canada (A.J., C.-P.S.F., L.M., B.W.M., C.M., M.K.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cedric","family":"Manlhiot","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children and University of Toronto, ON, Canada (A.J., C.-P.S.F., L.M., B.W.M., C.M., M.K.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark K.","family":"Friedberg","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children and University of Toronto, ON, Canada (A.J., C.-P.S.F., L.M., B.W.M., C.M., M.K.F.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912461"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.08.033"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.006191"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.12.042"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308787"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.000304"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2008.156612"},{"issue":"12","key":"e_1_3_2_9_2","first-page":"I82","article-title":"Improved survival of patients undergoing palliation of hypoplastic left heart syndrome: lessons learned from 115 consecutive patients.","volume":"106","author":"Tweddell JS","year":"2002","unstructured":"Tweddell, JS, Hoffman, GM, Mussatto, KA, Fedderly, RT, Berger, S, Jaquiss, RD, Ghanayem, NS, Frisbee, SJ, Litwin, SB. 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