{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T04:45:43Z","timestamp":1770525943088,"version":"3.49.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,6,18]]},"abstract":"\n Background<\/jats:title>\n \n A previous study reported histologic abnormalities in the pulmonary artery (\n PA<\/jats:styled-content>\n ) of patients with tetralogy of Fallot (\n TOF<\/jats:styled-content>\n ). However, the potential effect of these anatomical findings on\n PA<\/jats:styled-content>\n vascular function has not been studied. We hypothesized that\n TOF<\/jats:styled-content>\n patients had abnormal\n PA<\/jats:styled-content>\n vascular function, and that\n PA<\/jats:styled-content>\n vascular function was associated with exercise capacity.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n This a study of adult\n TOF<\/jats:styled-content>\n patients who had cardiac magnetic resonance imaging and echocardiogram (on the same day) at Mayo Clinic, 2002\u20132015. In order to test the study hypothesis, we compared\n PA<\/jats:styled-content>\n elastance index (\n PAE<\/jats:styled-content>\n i) between 207\n TOF<\/jats:styled-content>\n patients and a referent group of 8 subjects without structural heart disease.\n PAE<\/jats:styled-content>\n i was calculated as a quotient of\n PA<\/jats:styled-content>\n systolic pressure and cardiac magnetic resonance imaging\u2013derived right ventricular stroke volume. Mean age was 33\u00b113\u00a0and 36\u00b14\u00a0years in the\n TOF<\/jats:styled-content>\n and referent groups respectively.\n TOF<\/jats:styled-content>\n patients had higher\n PAE<\/jats:styled-content>\n i compared with the referent group (0.62\u00b10.12 versus 0.48\u00b10.08\u00a0mm\u00a0Hg\/\n mL<\/jats:styled-content>\n \/m\n 2<\/jats:sup>\n ;\n P<\/jats:italic>\n =0.001). There was a good correlation between\n PAE<\/jats:styled-content>\n i and peak oxygen consumption (adjusted\n R<\/jats:italic>\n 2<\/jats:sup>\n =0.73;\n r<\/jats:italic>\n =0.85;\n P<\/jats:italic>\n <0.001). After multivariate adjustment for potential confounders,\n PAE<\/jats:styled-content>\n i was independently associated with peak oxygen consumption (adjusted\n R<\/jats:italic>\n 2<\/jats:sup>\n =0.69;\n r<\/jats:italic>\n =0.83;\n P<\/jats:italic>\n <0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The high\n PA<\/jats:styled-content>\n elastance in the\n TOF<\/jats:styled-content>\n group may be attributed to abnormal\n PA<\/jats:styled-content>\n vascular function. The association between\n PAE<\/jats:styled-content>\n i and exercise intolerance suggests that\n PA<\/jats:styled-content>\n vascular dysfunction may contribute to exercise intolerance, which is an important clinical problem in this population. Further studies are required to validate our findings and explore potential therapies to improve\n PA<\/jats:styled-content>\n vascular function in this population.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011731","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T09:04:10Z","timestamp":1560243850000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Abnormal Pulmonary Arterial Elastance Is Associated With Reduced Exercise Capacity in Tetralogy of Fallot"],"prefix":"10.1161","volume":"8","author":[{"given":"Alexander C.","family":"Egbe","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic, Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandan S.","family":"Anavekar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic, Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi M.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic, Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)01886-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.06.040"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.06.078"},{"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":"10.1161\/CIRCULATIONAHA.118.034740"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.02.039"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu396"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy331"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw241"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu193"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004436"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.000553"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-13-9"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.04.013"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312048"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.067"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.309184"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2212"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.118.011731","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:51:02Z","timestamp":1715601062000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.118.011731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,18]]},"references-count":19,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,6,18]]}},"alternative-id":["10.1161\/JAHA.118.011731"],"URL":"https:\/\/doi.org\/10.1161\/jaha.118.011731","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,18]]},"assertion":[{"value":"2018-12-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e011731"}}