{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T15:00:25Z","timestamp":1765292425911,"version":"3.46.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,12,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Right ventricular (RV) to pulmonary arterial coupling (RVPAc) quantifies RV contractility in relation to its afterload but traditionally requires high\u2010fidelity catheter derived pressure\u2010volume loops. We sought to evaluate a noninvasive volume\u2010based RVPAc parameter in children and adults with repaired tetralogy of Fallot in relation to pulmonary regurgitation (PR), RV outflow tract obstruction (RVOTO), and exercise capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We retrospectively studied 92 pediatric and 105 adult patients with repaired tetralogy of Fallot who had cardiovascular magnetic resonance imaging and cardiopulmonary exercise testing within a 1\u2010year interval. RVPAc was calculated as the ratio of RV end\u2010systolic volume over stroke volume. RVOTO gradient was obtained by echocardiography; RV ejection fraction, and PR fraction by cardiovascular magnetic resonance imaging. Exercise capacity was measured as the percentage of predicted peak oxygen consumption during cardiopulmonary exercise testing. Subgroups were established depending on the combination of PR\u2010RVOTO (cutoff defined as PR &gt;30% and RVOTO &gt;25\u2009mm\u2009Hg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      RVPAc was significantly higher in adult versus pediatric patients (1.23 [1.03\u20131.48] versus 1.00 [0.88\u20131.15];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). RVPAc was comparable in the 4 pediatric hemodynamic subgroups (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.38) but tended to be higher in adults with either RVOTO, PR, or RVOTO+PR (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.05). RVPAc highly correlated with RVEF (r=\u22120.991,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) but was not associated with percentage of predicted peak oxygen consumption.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Worse RVPAc in adult versus pediatric patients with repaired tetralogy of Fallot may signify progressive RV\u2010PA uncoupling with age\u2010 or era\u2010related effects. However, the clinical use of volumetric RVPAc in repaired tetralogy of Fallot appears limited, as it does not provide additional information over RVEF and is not associated with exercise capacity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042371","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T12:14:58Z","timestamp":1764159298000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Noninvasive Assessment of Right Ventricular\u2010Pulmonary Arterial Coupling in Repaired Tetralogy of Fallot by Magnetic Resonance Imaging"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9332-0913","authenticated-orcid":false,"given":"Gilles","family":"Mets","sequence":"first","affiliation":[{"name":"Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children","place":["Toronto, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7053-3764","authenticated-orcid":false,"given":"Yuval","family":"Bitterman","sequence":"additional","affiliation":[{"name":"Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children","place":["Toronto, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2170-5942","authenticated-orcid":false,"given":"Laura","family":"Mercer\u2010Rosa","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Philadelphia","place":["Philadelphia, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2373-6438","authenticated-orcid":false,"given":"Rachel","family":"Wald","sequence":"additional","affiliation":[{"name":"Toronto General Hospital\/University Health Network","place":["Toronto, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4108-5560","authenticated-orcid":false,"given":"Mark K.","family":"Friedberg","sequence":"additional","affiliation":[{"name":"Labatt Family Heart Centre, Department of Pediatrics, Hospital for Sick Children","place":["Toronto, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"doi-asserted-by":"publisher","key":"e_1_3_1_2_2","DOI":"10.1152\/ajpheart.1983.245.5.H773"},{"doi-asserted-by":"publisher","key":"e_1_3_1_3_2","DOI":"10.1152\/ajpheart.1980.238.6.H932"},{"doi-asserted-by":"publisher","key":"e_1_3_1_4_2","DOI":"10.1002\/ehf2.14233"},{"doi-asserted-by":"publisher","key":"e_1_3_1_5_2","DOI":"10.1136\/heartjnl-2011-300462"},{"doi-asserted-by":"publisher","key":"e_1_3_1_6_2","DOI":"10.1016\/j.jcmg.2016.12.024"},{"doi-asserted-by":"publisher","key":"e_1_3_1_7_2","DOI":"10.1093\/eurheartj\/ehu193"},{"doi-asserted-by":"publisher","key":"e_1_3_1_8_2","DOI":"10.1016\/j.pcad.2016.06.001"},{"doi-asserted-by":"publisher","key":"e_1_3_1_9_2","DOI":"10.1016\/j.jacc.2009.06.040"},{"doi-asserted-by":"publisher","key":"e_1_3_1_10_2","DOI":"10.1016\/j.athoracsur.2013.05.085"},{"doi-asserted-by":"publisher","key":"e_1_3_1_11_2","DOI":"10.1016\/j.cjcpc.2023.10.009"},{"doi-asserted-by":"publisher","key":"e_1_3_1_12_2","DOI":"10.1161\/CIR.0000000000001291"},{"doi-asserted-by":"publisher","key":"e_1_3_1_13_2","DOI":"10.1016\/j.jtcvs.2013.02.039"},{"doi-asserted-by":"publisher","key":"e_1_3_1_14_2","DOI":"10.1016\/j.cjca.2019.03.009"},{"doi-asserted-by":"publisher","key":"e_1_3_1_15_2","DOI":"10.1016\/j.diii.2020.05.008"},{"doi-asserted-by":"publisher","key":"e_1_3_1_16_2","DOI":"10.1016\/j.echo.2022.11.008"},{"doi-asserted-by":"publisher","key":"e_1_3_1_17_2","DOI":"10.1016\/j.cjca.2014.06.011"},{"doi-asserted-by":"publisher","key":"e_1_3_1_18_2","DOI":"10.1016\/S0022-5223(19)38300-X"},{"key":"e_1_3_1_19_2","volume-title":"Clinical Exercise Testing","author":"Jones N","year":"1997","unstructured":"Jones N. 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