{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:31:08Z","timestamp":1787776268869,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n This study aimed to assess the accuracy of tricuspid spectral Doppler (E\/A) and tissue Doppler parameters (E\/E\u2019) to diagnose right ventricular diastolic dysfunction (RVDD) in comparison to American Society of Echocardiography (ASE criteria) in pediatric tetralogy of Fallot (TOF) patients after surgical repair.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This prospective, observational study was done at a tertiary care hospital involving 40 pediatric TOF patients aged less than 2 years who underwent complete intracardiac repair with cardiopulmonary bypass (CPB). Echocardiographic observations were made using a pediatric transesophageal echocardiography probe after surgical repair in the post-CPB period. The ASE-described parameters (late diastolic forward flow in the main pulmonary artery, right atrial dilatation, inferior vena cava dilatation, and hepatic venous flow reversal) were acquired to diagnose the RVDD. The tricuspid Doppler parameters (E\/A and E\/E\u2019) were measured, and its predictive ability to diagnose RVDD was analyzed and compared with the ASE criteria.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Based on the ASE criteria, 13 patients (32.5%) were diagnosed to have RVDD. We found that an E\/E\u2019 ratio of \u2265 6.26 and an E\/A ratio of >1.34 can be taken as the cutoff for diagnosing the RVDD. Based on the tricuspid Doppler parameters (E\/A > 1.34 and E\/E\u2019 >6.26), 17 patients (42.5%) were diagnosed to have RVDD, which was comparable to that of the diagnosis by ASE criteria (\n P<\/jats:italic>\n > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The results suggested that the use of tricuspid Doppler parameters can be equally accurate and reproducible to the current ASE-described echocardiographic parameters for diagnosing RVDD after surgical repair of TOF.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aca.aca_85_24","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T07:01:13Z","timestamp":1737702073000},"page":"53-60","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Accuracy of Intraoperative Transesophageal Echocardiographic Doppler Parameters in Assessing the Right Ventricular Diastolic Function After Repair of Tetralogy of Fallot in Pediatric Patients"],"prefix":"10.4103","volume":"28","author":[{"given":"Nagarjuna","family":"Panidapu","sequence":"first","affiliation":[{"name":"Department of Cardiac Anaesthesia, Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saravana","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baiju S.","family":"Dharan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barsha","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, Amrita Institute of Medical Sciences, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Koshy","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"R1-20250124","doi-asserted-by":"crossref","first-page":"e000690","DOI":"10.1136\/openhrt-2017-000690","article-title":"Late-stage left ventricular dysfunction in adult survivors of tetralogy of Fallot repair in childhood","volume":"4","author":"Anabtawi","year":"2017","journal-title":"Open Hear"},{"key":"R2-20250124","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1053\/j.jvca.2019.01.036","article-title":"Can echocardiographic right ventricular function parameters predict vasoactive support requirement after tetralogy of fallot repair?","volume":"33","author":"Krishna","year":"2019","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R3-20250124","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3389\/fcvm.2017.00005","article-title":"Assessment of diastolic function in congenital heart disease","volume":"4","author":"Panesar","year":"2017","journal-title":"Front Cardiovasc Med"},{"key":"R4-20250124","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1161\/01.CIR.91.6.1775","article-title":"Right ventricular diastolic function 15 to 35 years after repair of tetralogy of Fallot. Restrictive physiology predicts superior exercise performance","volume":"91","author":"Gatzoulis","year":"1995","journal-title":"Circulation"},{"key":"R5-20250124","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1136\/hrt.79.5.481","article-title":"Does restrictive right ventricular physiology in the early postoperative period predict subsequent right ventricular restriction after repair of tetralogy of Fallot?","volume":"79","author":"Norg\u00e5rd","year":"1998","journal-title":"Heart"},{"key":"R6-20250124","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.echo.2013.11.009","article-title":"Multimodality imaging guidelines for patients with repaired tetralogy of fallot:A report from the AmericanSsociety of Echocardiography:Developed in collaboration with the Society for Cardiovascular Magnetic Resonance and the Society for Pediatric Radiology","volume":"27","author":"Valente","year":"2014","journal-title":"J Am Soc Echocardiogr"},{"key":"R7-20250124","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.echo.2010.05.010","article-title":"Guidelines for the echocardiographic assessment of the right heart in adults:A report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography","volume":"23","author":"Rudski","year":"2010","journal-title":"J Am Soc Echocardiogr"},{"key":"R8-20250124","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement:Guidelines for reporting observational studies","volume":"61","author":"Von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"R9-20250124","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1161\/01.CIR.100.14.1540","article-title":"Acute right ventricular restrictive physiology after repair of tetralogy of Fallot:Association with myocardial injury and oxidative stress","volume":"100","author":"Chaturvedi","year":"1999","journal-title":"Circulation"},{"key":"R10-20250124","doi-asserted-by":"crossref","first-page":"e024036","DOI":"10.1161\/JAHA.121.024036","article-title":"End-diastolic forward flow and restrictive physiology in repaired tetralogy of fallot:A systematic review and meta-analysis","volume":"11","author":"Van den Eynde","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"R11-20250124","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4236\/wjcs.2014.48021","article-title":"Assessment of right ventricular function in post operative patients of tetralogy of fallots and its predictive factors","volume":"4","author":"Singh","year":"2014","journal-title":"World J Cardiovasc Surg"},{"key":"R12-20250124","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1161\/01.CIR.92.2.231","article-title":"Mechanoelectrical interaction in tetralogy of fallot","volume":"92","author":"Gatzoulis","year":"1995","journal-title":"Circulation"},{"key":"R13-20250124","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1093\/ehjci\/jes067","article-title":"Impaired right and left ventricular diastolic myocardial mechanics and filling in asymptomatic children and adolescents after repair of tetralogy of Fallot","volume":"13","author":"Friedberg","year":"2012","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"R14-20250124","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.ijcard.2020.02.067","article-title":"Echocardiographic predictors of severe right ventricular diastolic dysfunction in tetralogy of Fallot:Relations to patient outcomes","volume":"306","author":"Egbe","year":"2020","journal-title":"Int J Cardiol"},{"key":"R15-20250124","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/j.echo.2014.08.005","article-title":"Echocardiographic nomograms for chamber diameters and areas in Caucasian children","volume":"27","author":"Cantinotti","year":"2014","journal-title":"J Am Soc Echocardiogr"},{"key":"R16-20250124","doi-asserted-by":"crossref","first-page":"E113","DOI":"10.1111\/chd.12265","article-title":"Echocardiographic parameters of right ventricular diastolic function in repaired tetralogy of fallot are associated with important findings on magnetic resonance imaging","volume":"10","author":"Maskatia","year":"2015","journal-title":"Congenit Heart Dis"},{"key":"R17-20250124","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.cjca.2012.11.003","article-title":"Left and right ventricular diastolic function in adults with surgically repaired tetralogy of fallot:A multi-institutional study","volume":"29","author":"Aboulhosn","year":"2013","journal-title":"Can J Cardiol"},{"key":"R18-20250124","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/S0002-9149(98)00346-4","article-title":"Estimation of left and right ventricular filling pressures after heart transplantation by tissue Doppler imaging","volume":"82","author":"Sundereswaran","year":"1998","journal-title":"Am J Cardiol"},{"key":"R19-20250124","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1007\/s00246-012-0612-1","article-title":"Ratio of early diastolic tricuspid inflow to tricuspid lateral annulus velocity reflects pulmonary regurgitation severity but not right ventricular diastolic function in children with repaired tetralogy of fallot","volume":"34","author":"Hayabuchi","year":"2013","journal-title":"Pediatr Cardiol"},{"key":"R20-20250124","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":"R21-20250124","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1053\/j.jvca.2023.09.013","article-title":"Tricuspid Annular Plane Systolic Excursion (TAPSE) for the assessment of right ventricular function in adult and pediatric cardiac surgery:Modified two-dimensional and M-mode TAPSE by transesophageal echocardiography compared to M-mode TAPSE by transthoracic echocardiography","volume":"38","author":"Munaf","year":"2024","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R22-20250124","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1007\/s12630-017-0972-3","article-title":"The effect of pericardial incision on right ventricular systolic function:A prospective observational study","volume":"64","author":"Bitcon","year":"2017","journal-title":"Can J Anesth"},{"key":"R23-20250124","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1016\/j.echo.2013.06.022","article-title":"Tricuspid annular plane systolic excursion in the assessment of right ventricular function in children and adolescents after repair of tetralogy of fallot","volume":"26","author":"Mercer-Rosa","year":"2013","journal-title":"J Am Soc Echocardiogr"},{"key":"R24-20250124","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1590\/S0066-782X2003000200008","article-title":"Right ventricular diastolic dysfunction in the postoperative period of tetralogy of Fallot","volume":"80","author":"Cardoso","year":"2003","journal-title":"Arq Bras Cardiol"},{"key":"R25-20250124","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1093\/icvts\/ivt361","article-title":"Early and late outcomes of total repair of tetralogy of Fallot:Risk factors for late right ventricular dilatation","volume":"17","author":"Kim","year":"2013","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"R26-20250124","doi-asserted-by":"crossref","first-page":"3276","DOI":"10.1161\/01.CIR.94.12.3276","article-title":"Relationship between type of outflow tract repair and postoperative right ventricular diastolic physiology in tetralogy of fallot implications for long-term outcome","volume":"94","author":"Norg\u00e5rd","year":"1996","journal-title":"Circulation"},{"key":"R27-20250124","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/s002469900198","article-title":"Determinants of aerobic capacity during exercise following complete repair of tetralogy of Fallot with a transannular patch","volume":"18","author":"Mulla","year":"1997","journal-title":"Pediatr Cardiol"},{"key":"R28-20250124","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1177\/26324636221081592","article-title":"Incidence and type of right ventricular diastolic dysfunction in postoperative tetralogy of fallot pediatric patients","volume":"3","author":"Kidwai","year":"2022","journal-title":"Indian J Clin Cardiol"},{"key":"R29-20250124","doi-asserted-by":"crossref","first-page":"III123","DOI":"10.1161\/circ.102.suppl_3.III-123","article-title":"What is the optimal age for repair of tetralogy of Fallot?","volume":"102","author":"Van Arsdell","year":"2000","journal-title":"Circulation"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_85_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:02:17Z","timestamp":1787774537000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_85_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_85_24","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-04-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}