{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T13:19:53Z","timestamp":1781702393887,"version":"3.54.5"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1_supplement","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2006,7,4]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            The left ventricle (LV) adapts to chronic hypoxia by expressing protective angiogenic, metabolic, and antioxidant genes to improve O\n            <jats:sub>2<\/jats:sub>\n            delivery and energy production, and to minimize reoxygenation injury. The ability of the right ventricle (RV) to adapt to hypoxia in children with tetralogy of Fallot (TOF) is unknown.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Gene expression using real-time polymerase chain reaction was measured in RV myocardium obtained during surgical repair of TOF from 23 patients: 13 cyanotic and 10 acyanotic. Results were compared between the 2 groups and correlated with age at surgery, severity of cyanosis, and early postoperative course. The cyanotic patients were younger at surgery compared with acyanotic (5\u00b13 versus 9\u00b14 months;\n            <jats:italic>P<\/jats:italic>\n            =0.01), had higher hematocrit (43\u00b14 versus 38\u00b13 grams\/dL;\n            <jats:italic>P<\/jats:italic>\n            =0.004), and lower O\n            <jats:sub>2<\/jats:sub>\n            saturations (84\u00b14% versus 98\u00b12%; (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001). Cyanotic patients had a significantly lower expression of vascular endothelial growth factor (VEGF), glycolytic enzymes, and glutathione peroxidase (GPX) (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05), and a higher expression of collagen (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01) compared with acyanotic patients. Gene expression correlated inversely with severity of cyanosis ie, preoperative hematocrit (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01) and positively with preoperative saturation (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05). The relationship between gene expression and cyanosis was independent of age at surgery. Ca\n            <jats:sup>2+<\/jats:sup>\n            handling genes did not correlate with the severity of hypoxia. Lower angiogenic, glycolytic, and antioxidant gene expression correlated with increasing postoperative lactate (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.05).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            The RV fails to up regulate adaptive pathways in response to increasing hypoxia in children with TOF. The implications of an early maladaptive response of the RV on long-term RV function require further investigation.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.105.001248","type":"journal-article","created":{"date-parts":[[2006,7,7]],"date-time":"2006-07-07T01:56:58Z","timestamp":1152237418000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Failure of Right Ventricular Adaptation in Children With Tetralogy of Fallot"],"prefix":"10.1161","volume":"114","author":[{"given":"Sushma","family":"Reddy","sequence":"first","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Osorio","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Duque","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth D.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair B.","family":"Phillips","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Quaegebeur","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph S.","family":"Mosca","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Mital","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.R., J.C.O., A.M.D., B.D.K., S.M.) and Cardiothoracic Surgery (A.B.P., J.M.C., J.Q., R.S.M.), Department of Pediatrics, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(77)80221-X"},{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.91.6.1775"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02475-4"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00278.2005"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardiores.2003.11.033"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.shk.0000170352.72694.36"},{"key":"e_1_3_3_7_2","first-page":"1038","volume":"18","year":"2004","unstructured":"Huang Y, Hickey RP, Yeh JL, Liu D, Dadak A, Young LH, Johnson RS, Giordano FJ. 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