{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:29:18Z","timestamp":1792711758781,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,4,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Right ventricular outflow tract (RVOT) stenosis after repair of tetralogy of Fallot has been linked with favorable right ventricular remodeling but adverse outcomes. The aim of our study was to assess the hemodynamic impact and prognostic relevance of right ventricular pressure load in this population.<\/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                      A total of 296 patients with repaired tetralogy of Fallot (mean age, 17.8\u00b17.9\u00a0years) were included in a prospective cardiovascular magnetic resonance multicenter study. Myocardial strain was quantified by feature tracking technique at study entry. Follow\u2010up, including the need for pulmonary valve replacement, was assessed. The combined end point consisted of ventricular tachycardia and cardiac death. A higher echocardiographic RVOT peak gradient was significantly associated with smaller right ventricular volumes and less pulmonary regurgitation, but lower biventricular longitudinal strain. During a follow\u2010up of 10.1 (0.1\u201312.9) years, the primary end point was reached in 19 of 296 patients (cardiac death, n=6; sustained ventricular tachycardia, n=2; and nonsustained ventricular tachycardia, n=11). A higher RVOT gradient was associated with the combined outcome (hazard ratio [HR], 1.03; 95% CI, 1.00\u20131.06;\n                      <jats:italic>P<\/jats:italic>\n                      =0.026), and a cutoff gradient of \u226525\u00a0mm\u00a0Hg was predictive for cardiovascular events (HR, 3.69; 95% CI, 1.47\u20139.27;\n                      <jats:italic>P<\/jats:italic>\n                      =0.005). In patients with pulmonary regurgitation \u226525%, a mild residual RVOT gradient (15\u201330\u00a0mm\u00a0Hg) was not associated with a lower risk for pulmonary valve replacement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Higher RVOT gradients were associated with less pulmonary regurgitation and smaller right ventricular dimensions but were related to reduced biventricular strain and emerged as univariate predictors of adverse events. Mild residual pressure gradients did not protect from pulmonary valve replacement. These results may have implications for the indication for RVOT reintervention in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.022694","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T05:31:41Z","timestamp":1647581501000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Impact of Right Ventricular Pressure Load After Repair of Tetralogy of Fallot"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3939-6025","authenticated-orcid":false,"given":"Heiner","family":"Latus","sequence":"first","affiliation":[{"name":"Clinic for Pediatric Cardiology and Congenital Heart Disease German Heart Centre Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Stammermann","sequence":"additional","affiliation":[{"name":"Pediatric Heart Centre Giessen 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