{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:54:43Z","timestamp":1787500483481,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,7,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cardiac MRI (CMR) derived ventricular global function index (GFI), a ratio of stroke volume to the sum of mean ventricular cavity and myocardial volumes, has demonstrated improved prediction of clinical outcomes in adults with atherosclerotic disease over ejection fraction. We sought to assess CMR derived GFI and a novel modification that accounts for unique loading conditions in patients with repaired tetralogy of Fallot (rTOF) and determine its correlation with exercise performance.<\/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                      Seventy\u2010five patients with rTOF who underwent CMR were identified. Clinical variables were recorded and biventricular GFI calculated. A right ventricular (RV) effective GFI (eGFI) was derived by incorporating effective stroke volume. Thirty\u2010five pediatric patients were matched with 29 age\u2010matched healthy controls. Twenty\u2010five patients completed cardiopulmonary exercise tests within 6\u00a0months of CMR. Stepwise regression models were used to determine univariate and multivariable predictors of indexed and percent predicted peak VO\n                      <jats:sub>2<\/jats:sub>\n                      . Median age at CMR was 20\u00a0years (interquartile range, 13\u201328). Pediatric rTOF patients had lower RV eGFI (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), RV ejection fraction (\n                      <jats:italic>P<\/jats:italic>\n                      =0.002), but higher indexed RV end\u2010diastolic and end\u2010systolic volumes (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) compared with controls. Univariate analysis demonstrated a correlation between indexed peak VO\n                      <jats:sub>2<\/jats:sub>\n                      with RV eGFI (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      =0.32,\n                      <jats:italic>P<\/jats:italic>\n                      =0.004), but with neither RVGFI, RV ejection fraction, indexed RV volumes nor RV mass. RV eGFI remained significantly associated with indexed peak VO\n                      <jats:sub>2<\/jats:sub>\n                      during multivariable modeling.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Reduced RV eGFI was associated with reduced exercise capacity in rTOF patients, while RV GFI, RV ejection fraction, indexed RV volumes and mass were not. Our modification of the GFI, RV eGFI, may be a valuable non\u2010invasive marker of cardiac function in rTOF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.016308","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T05:43:22Z","timestamp":1594100602000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Modified Ventricular Global Function Index Correlates With Exercise Capacity in Repaired Tetralogy of Fallot"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3111-2817","authenticated-orcid":false,"given":"Hieu T.","family":"Ta","sequence":"first","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8634-1399","authenticated-orcid":false,"given":"Paul J.","family":"Critser","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3777-4822","authenticated-orcid":false,"given":"Tarek","family":"Alsaied","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Germann","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5537-032X","authenticated-orcid":false,"given":"Adam W.","family":"Powell","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6616-6316","authenticated-orcid":false,"given":"Andrew N.","family":"Redington","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-3752","authenticated-orcid":false,"given":"Justin T.","family":"Tretter","sequence":"additional","affiliation":[{"name":"Heart Institute Cincinnati Children\u2019s Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.06.050"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-13-9"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.07.120"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034740"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.037000"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.117.007410"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.005"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.025795"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-004-2191-y"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc2844"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00785.2012"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.01.017"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.198028"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000164273.57823.26"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey123"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1656-z"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.2014.919223"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12661"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-199709000-00019"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-2586(199911)10:5<602::AID-JMRI3>3.0.CO;2-C"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000030995.59403.F8"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.107"},{"key":"e_1_3_1_25_2","volume-title":"Principles of Exercise Testing and Interpretation: Including Pathophysiology and Clinical Applications","author":"Wasserman KHJ","year":"1999","unstructured":"Wasserman KHJ, Sue DY, Casaburi R,Whipp BJ. Principles of Exercise Testing and Interpretation: Including Pathophysiology and Clinical Applications. Philadelphia, PA: Lippincott, Williams & Wilkins; 1999."},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1984.56.3.628"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005878"},{"key":"e_1_3_1_28_2","first-page":"1","article-title":"Right ventricular systolic dysfunction but not dilatation correlates with prognostically significant reductions in exercise capacity in repaired tetralogy of Fallot","volume":"0","author":"Rashid I","year":"2019","unstructured":"Rashid I, Mahmood A, Ismail TF, O\u2019Meagher S, Kutty S, Celermajer D, Puranik R. Right ventricular systolic dysfunction but not dilatation correlates with prognostically significant reductions in exercise capacity in repaired tetralogy of Fallot. Eur Heart J Cardiovasc Imaging. 2019;0:1\u20138.","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jes137"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-015-0111-7"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.016308","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T03:25:28Z","timestamp":1738812328000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.016308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,21]]},"references-count":29,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2020,7,21]]}},"alternative-id":["10.1161\/JAHA.120.016308"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.016308","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,21]]},"assertion":[{"value":"2020-02-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e016308"}}