{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:02:10Z","timestamp":1790802130739,"version":"4.1.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The aim of this study was to identify in asymptomatic patients with repaired tetralogy of Fallot the prevalence and determinants of impaired left\u2010sided cardiac function and adverse ventricular remodeling and the relation of left ventricular (LV) dysfunction and remodeling with cardiopulmonary exercise capacity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In a cross\u2010sectional study, 103 patients with tetralogy of Fallot (median age, 16.3\u00a0years) in New York Heart Association class 1, with surgical repair at a median age of 1.1\u00a0years, and 63 age\u2010matched controls were studied. LV, right ventricular function and geometry, LV myocardial extracellular volume (n=57), and left atrial function were quantified with cardiac magnetic resonance. Peak oxygen consumption was measured by a standardized cardiopulmonary exercise test (n=70). Patients with tetralogy of Fallot had lower LV ejection fraction (\n              <jats:italic>P<\/jats:italic>\n              =0.001; 49% below age\u2010adjusted fifth percentile for controls), lower LV mass index (\n              <jats:italic>P<\/jats:italic>\n              =0.003), lower LV mass\/volume ratio (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), and impaired left atrial function. Right ventricular mass\/volume ratio was the best predictor for LV systolic dysfunction and for a lower LV mass\/volume ratio. Compared with controls, LV extracellular volume was higher (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), particularly in female patients, and associated with subnormal peak oxygen consumption (\n              <jats:italic>P<\/jats:italic>\n              =0.037). A peak oxygen consumption below the third percentile reference level was more likely with decreasing LV ejection fraction (\n              <jats:italic>P<\/jats:italic>\n              =0.008), and lower LV mass index (\n              <jats:italic>P<\/jats:italic>\n              =0.024), but independent of right ventricular ejection fraction.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In New York Heart Association class 1 patients with tetralogy of Fallot, frequent impaired systolic and diastolic LV function, LV adverse remodeling with LV atrophy, a decreased mass\/volume ratio, and extracellular matrix expansion suggest cardiomyopathic changes. The best predictor for LV systolic dysfunction was the right ventricular mass\/volume ratio. The subnormal peak oxygen consumption indicates that monitoring of LV status may be important for long\u2010term prognosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.009618","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T09:04:12Z","timestamp":1567242252000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Determinants of Left Ventricular Dysfunction and Remodeling in Patients With Corrected Tetralogy of Fallot"],"prefix":"10.1161","volume":"8","author":[{"given":"Ana Cristina","family":"Andrade","sequence":"first","affiliation":[{"name":"Heart Institute Medical School of S\u00e3o Paulo University S\u00e3o Paulo Brazil"},{"name":"Department of Congenital Heart Disease and Pediatric Cardiology University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Jerosch\u2010Herold","sequence":"additional","affiliation":[{"name":"Department of Radiology Brigham &amp; Women's Hospital and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Wegner","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik Daniel","family":"Gabbert","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Voges","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Radiology Brigham &amp; Women's Hospital and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Hedderich","sequence":"additional","affiliation":[{"name":"Department for Medical Informatics and Statistics University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Heiner","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Rickers","sequence":"additional","affiliation":[{"name":"University Heart Center Adult with Congenital Heart Disease Unit University Hospital Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-13-9"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009454"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02566-4"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304958"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-015-0111-7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.108.842096"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.05.174"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-10-35"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.07.022"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.06.007"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-13-42"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.09.011"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.066"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00429.2008"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951108003181"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.06.029"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr461"},{"key":"e_1_3_2_19_2","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2015","unstructured":"R Core Team . 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