{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:54:18Z","timestamp":1783464858842,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T00:00:00Z","timestamp":1665187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Key Clinical Specialties Construction Program, National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171902"],"award-info":[{"award-number":["82171902"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Key Clinical Specialties Construction Program, National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["17411965400"],"award-info":[{"award-number":["17411965400"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Committee of Science and Technology","award":["82171902"],"award-info":[{"award-number":["82171902"]}]},{"name":"Shanghai Committee of Science and Technology","award":["17411965400"],"award-info":[{"award-number":["17411965400"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>(1) Background: The left atrium (LA) is much more than a reservoir for left ventricular filling. The aim of this study was to assess the LA volume and function in patients with repaired pulmonary artery atresia with ventricular septal defect (rPA\/VSD) using CMR. (2) Methods: 31 pediatric patients with rPA\/VSD and 30 healthy controls were prospectively recruited. Left atrial ejection fraction (EF), strain and strain rate of three phases (reservoir, conduit, and pump) and left atrial volume were measured with cardiac function analysis software. (3) Results: Patients with rPA\/VSD had decreased maximal volume index (p = 0.008). Compared to controls, LA reservoir strain and strain rate, conduit strain and strain rate, booster pump strain rate, total EF and passive EF were significantly lower (p = 0.001, p &lt; 0.001, p = 0.001, p = 0.02, p = 0.03, p &lt; 0.001, p &lt; 0.001); the patients with preserved but lower RVEF(&lt;50%) had lower reservoir strain, reservoir strain rate and pump strain rate (p = 0.01, p = 0.02, p = 0.04, respectively) than the patients with higher RVEF (\u226550%). (4) Conclusions: In patients with rPA\/VSD, LA function was altered when biventricular EF was preserved, which may provide an early indication of left ventricular diastolic dysfunction. CMR can detect LA dysfunction at an early stage, even before LA enlargement.<\/jats:p>","DOI":"10.3390\/children9101536","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T20:43:21Z","timestamp":1665261801000},"page":"1536","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Left Atrial Dysfunction in Children with Repaired Pulmonary Artery Atresia with Ventricular Septal Defect: A Cardiovascular Magnetic Resonance Imaging Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Yanyan","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwei","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongzhen","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinglei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumin","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200120, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1093\/ejcts\/ezv404","article-title":"Long-term outcome after treatment of pulmonary atresia with ventricular septal defect: Nationwide study of 109 patients born in 1970-2007","volume":"49","author":"Kaskinen","year":"2016","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/jmri.27034","article-title":"Right and left ventricular interactions, strain, and remodeling in repaired pulmonary stenosis patients with preserved right ventricular ejection fraction: A cardiac magnetic resonance study","volume":"52","author":"Wang","year":"2020","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6156","DOI":"10.1007\/s00330-020-07643-6","article-title":"Detection of persistent systolic and diastolic abnormalities in asymptomatic pediatric repaired tetralogy of Fallot patients with preserved ejection fraction: A CMR feature tracking study","volume":"31","author":"Ouyang","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3255","DOI":"10.1007\/s10554-021-02302-3","article-title":"Impairment of left atrial function in pediatric patients with repaired tetralogy of Fallot: A cardiovascular magnetic resonance imaging study","volume":"37","author":"Hu","year":"2021","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.hfc.2018.12.001","article-title":"Importance of the Left Atrium: More Than a Bystander?","volume":"15","author":"Kebed","year":"2019","journal-title":"Heart Fail. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1007\/s00246-020-02351-w","article-title":"Atrial Function and Its Role in the Non-invasive Evaluation of Diastolic Function in Congenital Heart Disease","volume":"41","author":"Ta","year":"2020","journal-title":"Pediatr. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/j.jacc.2017.07.758","article-title":"Left Atrial Fibrosis and Risk of Cerebrovascular and Cardiovascular Events in Patients With Atrial Fibrillation","volume":"70","author":"King","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1476-7120-9-34","article-title":"Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy","volume":"9","author":"Tani","year":"2011","journal-title":"Cardiovasc. Ultrasound"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1148\/radiol.2019190559","article-title":"Left Atrial Function with MRI Enables Prediction of Cardiovascular Events after Myocardial Infarction: Insights from the AIDA STEMI and TATORT NSTEMI Trials","volume":"293","author":"Schuster","year":"2019","journal-title":"Radiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","article-title":"Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"29","author":"Nagueh","year":"2016","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.jcmg.2014.01.016","article-title":"Association of CMR-measured LA function with heart failure development: Results from the MESA study","volume":"7","author":"Habibi","year":"2014","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1532-429X-15-29","article-title":"Reference right atrial dimensions and volume estimation by steady state free precession cardiovascular magnetic resonance","volume":"15","author":"Maceira","year":"2013","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1136\/heartjnl-2012-301964","article-title":"Pulmonary stenosis: Update on diagnosis and therapeutic options","volume":"99","author":"Cuypers","year":"2013","journal-title":"Heart"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.diii.2020.05.008","article-title":"Differences in right ventricular-pulmonary vascular coupling and clinical indices between repaired standard tetralogy of Fallot and repaired tetralogy of Fallot with pulmonary atresia","volume":"102","author":"Buddhe","year":"2021","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/s12968-021-00780-x","article-title":"Right-left ventricular shape variations in tetralogy of Fallot: Associations with pulmonary regurgitation","volume":"23","author":"Mauger","year":"2021","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/echo.12611","article-title":"Atrial mechanics after surgical repair of tetralogy of Fallot","volume":"32","author":"Hou","year":"2015","journal-title":"Echocardiography"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1177\/1089253220920480","article-title":"Tetralogy of Fallot with Pulmonary Atresia: Anatomy, Physiology, Imaging, and Perioperative Management","volume":"25","author":"Ganigara","year":"2021","journal-title":"Semin. Cardiothorac. Vasc. Anesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12968-014-0060-6","article-title":"Quantification of left atrial strain and strain rate using Cardiovascular Magnetic Resonance myocardial feature tracking: A feasibility study","volume":"16","author":"Kowallick","year":"2014","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2788","DOI":"10.1007\/s00330-020-07399-z","article-title":"Reproducibility of left atrial function using cardiac magnetic resonance imaging","volume":"31","author":"Alfuhied","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.ijcard.2017.06.121","article-title":"Abnormal right atrial performance in repaired tetralogy of Fallot: A CMR feature tracking analysis","volume":"248","author":"Kutty","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_22","first-page":"H476","article-title":"Quantitative assessment of independent contributions of pericardium and septum to direct ventricular interaction","volume":"275","author":"Baker","year":"1998","journal-title":"Am. J. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1161\/01.CIR.100.4.427","article-title":"Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function","volume":"100","author":"Barbier","year":"1999","journal-title":"Circulation"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1161\/CIRCULATIONAHA.113.001375","article-title":"Right versus left ventricular failure: Differences, similarities, and interactions","volume":"129","author":"Friedberg","year":"2014","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2266","DOI":"10.1093\/eurheartj\/ehp258","article-title":"Improvement in left ventricular filling properties after relief of right ventricle to pulmonary artery conduit obstruction: Contribution of septal motion and interventricular mechanical delay","volume":"30","author":"Lurz","year":"2009","journal-title":"Eur. Heart J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"H1533","DOI":"10.1152\/ajpheart.00837.2006","article-title":"Wave intensity analysis of left atrial mechanics and energetics in anesthetized dogs","volume":"292","author":"Hobson","year":"2007","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/cvr\/21.4.255","article-title":"Left atrial filling in normal human subjects: Relation between left atrial contraction and left atrial early filling","volume":"21","author":"Toma","year":"1987","journal-title":"Cardiovasc. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ijcard.2019.02.018","article-title":"Implications of atrial volumes in surgical corrected Tetralogy of Fallot on clinical adverse events","volume":"283","author":"Lurz","year":"2019","journal-title":"Int. J. Cardiol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/10\/1536\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:48:17Z","timestamp":1760143697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/10\/1536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,8]]},"references-count":28,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["children9101536"],"URL":"https:\/\/doi.org\/10.3390\/children9101536","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,8]]}}}