{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T18:56:15Z","timestamp":1784141775741,"version":"3.55.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Left ventricular dysfunction in Ebstein\u2019s anomaly (EA) is associated with higher mortality. The health of the left ventricular myocardium in children and adolescents with EA has not been investigated in detail.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Patients with unrepaired EA who had undergone cardiac magnetic resonance imaging including T1 mapping were retrospectively reviewed. Patients were compared with age- and sex-matched controls. EA severity index was calculated using volumetric measurements at end diastole ([right atrial+atrialized right ventricular volumes]\/[functional right ventricular+left atrial+left ventricular volumes]). Global circumferential and radial strain and as well as strain rate were examined using cardiac magnetic resonance feature tracking.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Twelve EA patients and an equal number of controls were included. Functional and atrialized right ventricular end-diastolic volumes were 84\u00b115 and 21\u00b113 mL\/m\n              <jats:sup>2<\/jats:sup>\n              , respectively. Late gadolinium enhancement, confined to the right ventricle, was found in 2 patients (16%). Left ventricular native T1 values and extracellular volume fractions were higher in patients compared with controls (1026\u00b147 versus 956\u00b140 ms,\n              <jats:italic>P<\/jats:italic>\n              =0.0004 and 28.5\u00b13.4% versus 22.5\u00b12.6%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001, respectively). Native T1 times correlated inversely with patients\u2019 age, body surface area, and O\n              <jats:sub>2<\/jats:sub>\n              saturations (r=\u22120.63, \u22120.62, and \u22120.91, respectively;\n              <jats:italic>P<\/jats:italic>\n              =0.02,\n              <jats:italic>P<\/jats:italic>\n              =0.02, and\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001, respectively). EA severity index ranged between 0.15 and 0.94 and correlated with T1 values (r=0.76,\n              <jats:italic>P<\/jats:italic>\n              =0.003). Native T1 correlated with global circumferential strain (r=0.58,\n              <jats:italic>P<\/jats:italic>\n              =0.04) but not ejection fraction (EF). EA patients had reduced maximum oxygen uptake (V\n              <jats:sc>o<\/jats:sc>\n              <jats:sub>2<\/jats:sub>\n              max). V\n              <jats:sc>o<\/jats:sc>\n              <jats:sub>2<\/jats:sub>\n              max correlated inversely with T1 values (r=\u22120.79,\n              <jats:italic>P<\/jats:italic>\n              =0.01).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>\n              Children and adolescents with EA experience an abnormal degree of diffuse myocardial fibrosis. Its association with O\n              <jats:sub>2<\/jats:sub>\n              saturation points toward a role of hypoxemia in the pathogenesis of fibrosis. Larger and prospective studies are needed to evaluate the value of T1 mapping for risk stratification and monitoring in EA.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.120.011136","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T09:21:41Z","timestamp":1615886501000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Myocardial Fibrosis in Pediatric Patients With Ebstein\u2019s Anomaly"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1823-453X","authenticated-orcid":true,"given":"Safwat","family":"Aly","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics (S.A., M.S., L.G.-W.), The Hospital for Sick Children, University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7330-234X","authenticated-orcid":true,"given":"Mike","family":"Seed","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics (S.A., M.S., L.G.-W.), The Hospital for Sick Children, University of Toronto, Ontario, Canada."},{"name":"Department of Diagnostic Imaging (M.S., S.-J.Y., C.L.), The Hospital for Sick Children, University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9952-8504","authenticated-orcid":true,"given":"Shi-Joon","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging (M.S., S.-J.Y., C.L.), The Hospital for Sick Children, University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging (M.S., S.-J.Y., C.L.), The Hospital for Sick Children, University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1185-3805","authenticated-orcid":true,"given":"Lars","family":"Grosse-Wortmann","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Paediatrics (S.A., M.S., L.G.-W.), The Hospital for Sick Children, University of Toronto, Ontario, Canada."},{"name":"Division of Cardiology, Department of Pediatrics, Doernbecher Children\u2019s Hospital, Oregon Health and Science University, Portland (L.G.-W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"174","article-title":"Morphologic spectrum of Ebstein\u2019s anomaly of the heart: a review.","volume":"54","author":"Anderson KR","year":"1979","unstructured":"Anderson, KR, Zuberbuhler, JR, Anderson, RH, Becker, AE, Lie, JT. Morphologic spectrum of Ebstein\u2019s anomaly of the heart: a review. Mayo Clin Proc. 1979;54:174\u2013180. https:\/\/pubmed.ncbi.nlm.nih.gov\/431123\/. 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