{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:53:42Z","timestamp":1790841222644,"version":"4.1.0"},"reference-count":69,"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\">Pulmonary arterial end\u2010diastolic forward flow (EDFF) following repaired tetralogy of Fallot has been thought to represent right ventricular (RV) restrictive physiology, but is not fully understood. This systematic review and meta\u2010analysis sought to clarify its physiological and clinical correlates, and to define a framework for understanding EDFF and RV restrictive physiology.<\/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\">PubMed\/MEDLINE, Embase, Scopus, and reference lists of relevant articles were searched for observational studies published before March 2021. Random\u2010effects meta\u2010analysis was performed to identify factors associated with EDFF. Forty\u2010two individual studies published between 1995 and 2021, including a total of 2651 participants (1132 with EDFF; 1519 with no EDFF), met eligibility criteria. The pooled estimated prevalence of EDFF among patients with repaired tetralogy of Fallot was 46.5% (95% CI, 41.6%\u201351.3%). Among patients with EDFF, the use of a transannular patch was significantly more common, and their stay in the intensive care unit was longer. EDFF was associated with greater RV indexed volumes and mass, as well as smaller E\u2010wave velocity at the tricuspid valve. Finally, pulmonary regurgitation fraction was greater in patients with EDFF, and moderate to severe pulmonary regurgitation was more common in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">EDFF is associated with dilated, hypertrophied RVs and longstanding pulmonary regurgitation. Although several studies have defined RV restrictive physiology as the presence of EDFF, our study found no clear indicators of poor RV compliance in patients with EDFF, suggesting that EDFF may have multiple causes and might not be the precise equivalent of RV restrictive physiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.024036","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T05:32:22Z","timestamp":1647581542000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["End\u2010Diastolic Forward Flow and Restrictive Physiology in Repaired Tetralogy of Fallot: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5606-376X","authenticated-orcid":false,"given":"Jef","family":"Van den Eynde","sequence":"first","affiliation":[{"name":"Helen B. Taussig Heart Center The Johns Hopkins Hospital and School of Medicine Baltimore MD"},{"name":"Department of Cardiovascular Diseases University Hospitals Leuven and Department of Cardiovascular SciencesKU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2398-1900","authenticated-orcid":false,"given":"Emilie","family":"Derdeyn","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8146-9692","authenticated-orcid":false,"given":"Art","family":"Schuermans","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases University Hospitals Leuven and Department of Cardiovascular SciencesKU Leuven Leuven Belgium"},{"name":"Division of Cardiovascular Medicine Radcliffe Department of Medicine Oxford Cardiovascular Clinical Research Facility University of Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3661-8059","authenticated-orcid":false,"given":"Pushpa","family":"Shivaram","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Augusta University Augusta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5850-5413","authenticated-orcid":false,"given":"Werner","family":"Budts","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases University Hospitals Leuven and Department of Cardiovascular SciencesKU Leuven Leuven Belgium"},{"name":"Congenital and Structural Cardiology UZ Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Danford","sequence":"additional","affiliation":[{"name":"Helen B. Taussig Heart Center The Johns Hopkins Hospital and School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9428-0979","authenticated-orcid":false,"given":"Shelby","family":"Kutty","sequence":"additional","affiliation":[{"name":"Helen B. Taussig Heart Center The Johns Hopkins Hospital and School of Medicine Baltimore MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.025"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60657-7"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.67.6.470"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2016-000564"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.6.1782"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.6.1775"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.79.5.481"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951100005187"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(85)80220-5"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951100007988"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00387-7"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.08.021"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.03.019"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2431060213"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2012.05.011"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.04.021"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2006.04.004"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.12.188"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.203190"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.09.057"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.04.048"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0066-782X2003000200008"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.14.1540"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-018-2009-2"},{"key":"e_1_3_2_32_2","first-page":"1340","article-title":"Evidence for restoration of genetic growth potential","volume":"5500","author":"Cheung MMH","year":"2003","unstructured":"Cheung MMH, Davis AM, Wilkinson JL, Weintraub RG. Evidence for restoration of genetic growth potential. Congenit Heart Dis. 2003;5500:1340\u20131343. doi: 10.1136\/heart.89.11.1340","journal-title":"Congenit Heart Dis"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2007.02.020"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.73.5.445"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002469900260"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.5603\/KP.a2018.0145"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.07.132"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2018.02.025"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0476-4"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.04.008"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.02.011"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.01.278"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12265"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.01.008"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00351-9"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet009"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.12.3276"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivs150"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.09.009"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1177\/021849230601400403"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-005-1186-y"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-019-0909-8"},{"key":"e_1_3_2_53_2","first-page":"87","article-title":"Assessment of right ventricular myocardial fibrosis and restrictive physiology in patients with repaired tetralogy of fallot: a comparison between cardiac magnetic resonance and transthoracic echocardiography","volume":"21","author":"Sani ZA","year":"2020","unstructured":"Sani ZA, Samiei N, Khajali Z, Mirrazeghi F, Gholamipoor D, Rouzitalab M, Bayat M, Behjati M, Ghadrdoost B, Rahimi S. Assessment of right ventricular myocardial fibrosis and restrictive physiology in patients with repaired tetralogy of fallot: a comparison between cardiac magnetic resonance and transthoracic echocardiography. Iran Heart J. 2020;21:87\u201397.","journal-title":"Iran Heart J"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00598-1"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezw049"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5385-3"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab098"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1017\/S104795110600120X"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12166"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.653576"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz552"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90591-8"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.10.026"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14113"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951115002255"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.121.009101"},{"key":"e_1_3_2_67_2","first-page":"S0003\u20104975(20)3","article-title":"Pulmonary valve replacement in tetralogy of Fallot: an updated meta\u2010analysis","author":"Van den Eynde J","year":"2020","unstructured":"Van den Eynde J, S\u00e1 MPBO, Vervoort D, Roever L, Meyns B, Budts W, Gewillig M, Ruhparwar A, Zhigalov K, Weymann A. Pulmonary valve replacement in tetralogy of Fallot: an updated meta\u2010analysis. Ann Thorac Surg. 2020:S0003\u20104975(20)32173\u20101. doi: 10.1016\/j.athoracsur.2020.11.040","journal-title":"Ann Thorac Surg"},{"key":"e_1_3_2_68_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022909"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab283"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.18141"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.024036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:33:44Z","timestamp":1715585624000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.024036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,5]]},"references-count":69,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,4,5]]}},"alternative-id":["10.1161\/JAHA.121.024036"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.024036","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,5]]},"assertion":[{"value":"2021-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e024036"}}