{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:57:49Z","timestamp":1790175469257,"version":"4.1.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2012,5,22]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Sudden cardiac death and life-threatening ventricular arrhythmia remain a concern in adult patients with repaired tetralogy of Fallot. Longitudinal left ventricular (LV) function is sensitive in detecting early myocardial damage and may have prognostic implications in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      We included 413 tetralogy of Fallot patients (age, 36\u00b113 years; QRS duration, 148\u00b127 milliseconds; LV ejection fraction, 55\u00b110%). A composite end point of sudden cardiac death\/life-threatening ventricular arrhythmia (sustained ventricular  tachycardia, resuscitated sudden cardiac death, or appropriate implantable cardioverter-defibrillator discharge) was used. During a median follow-up of 2.9 years, 5 patients died suddenly, 9 had documented sustained ventricular  tachycardia, and another 5 had appropriate implantable cardioverter-defibrillator shocks. On univariate Cox analysis, QRS duration (hazard ratio [HR], 1.02 per 1 ms;\n                      <jats:italic>P<\/jats:italic>\n                      =0.046), right atrial area (HR, 1.05 per 1 cm\n                      <jats:sup>2<\/jats:sup>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      =0.02), right ventricular fractional area change (HR, 0.94 per 1%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.02), right ventricular outflow tract diameter (HR, 1.08 per 1 mm;\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), mitral annular plane systolic excursion (HR, 0.84 per 1 mm;\n                      <jats:italic>P<\/jats:italic>\n                      =0.03), and LV global longitudinal 2-dimensional strain (HR, 0.87 per 1%;\n                      <jats:italic>P<\/jats:italic>\n                      =0.03) were related to the combined end point. On bivariable analysis, mitral annular plane systolic excursion and LV global longitudinal 2-dimensional strain were related to outcome independently of QRS duration (\n                      <jats:italic>P<\/jats:italic>\n                      =0.002 and\n                      <jats:italic>P<\/jats:italic>\n                      =0.01, respectively). In addition, a combination of echocardiographic variables, including right atrial area, right ventricular fractional area change, and LV global longitudinal 2-dimensional strain or mitral annular plane systolic excursion, was also found to be significantly related to outcome (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001; c statistic, 0.70).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>LV longitudinal dysfunction was associated with greater risk of sudden cardiac death\/life-threatening ventricular arrhythmias. In combination with echocardiographic right heart variables, also available from routine echocardiography, these measures provide important outcome information and should be considered a useful adjunct to established markers such as QRS duration in the estimation of prognosis in this challenging population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.111.086983","type":"journal-article","created":{"date-parts":[[2012,4,12]],"date-time":"2012-04-12T01:40:05Z","timestamp":1334194805000},"page":"2440-2446","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":247,"title":["Left Ventricular Longitudinal Function Predicts Life-Threatening Ventricular Arrhythmia and Death in Adults With Repaired Tetralogy of Fallot"],"prefix":"10.1161","volume":"125","author":[{"given":"Gerhard-Paul","family":"Diller","sequence":"first","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Kempny","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Liodakis","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Alonso-Gonzalez","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Inuzuka","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anselm","family":"Uebing","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Orwat","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna","family":"Swan","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Gatzoulis","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"From the Adult Congenital and Valvular Heart Disease Center, Department of Cardiology and Angiology, University Hospital of M\u00fcnster, M\u00fcnster, Germany (G.-P.D., A.K., S.O., H.B.); Adult Congenital Heart Disease Program, Royal Brompton Hospital, London, UK (G.-P.D., A.K., E.L., R.A.-G., R.I., A.U., K.D., L.S., W.L., M.A.G.); and Imperial College of Science and Medicine, London, UK (G.-P.D., K.D., M.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.592345"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.88.5.510"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.67.6.470"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951102001002"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a060070"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80116-0"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02714-8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.775221"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1586\/erc.09.38"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.726372"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02344-6"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.12.026"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02566-4"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.10.018"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.69.6.501"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.09.031"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.63.4.215"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.82.2.192"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00421-L"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.571455"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.81.2.111"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.688770"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euje.2005.12.014"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jep007"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.15.1788"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1"},{"key":"e_1_3_3_28_2","unstructured":"R Development Core Team. 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