array:24 [
  "pii" => "S2174204916302707"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2016.12.005"
  "estado" => "S300"
  "fechaPublicacion" => "2017-01-01"
  "aid" => "920"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2017;36:31-3"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1832
    "formatos" => array:3 [
      "EPUB" => 186
      "HTML" => 1296
      "PDF" => 350
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S087025511630347X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2016.11.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-01-01"
      "aid" => "920"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "dis"
      "cita" => "Rev Port Cardiol. 2017;36:31-3"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 3023
        "formatos" => array:3 [
          "EPUB" => 208
          "HTML" => 2321
          "PDF" => 494
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
        "titulo" => "Right ventricular speckle tracking echocardiography&#58; A new tool for decision-making after surgical repair of tetralogy of Fallot&#63;"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "31"
            "paginaFinal" => "33"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Ecocardiografia de <span class="elsevierStyleItalic">speckle tracking</span> do ventr&#237;culo direito&#58; uma nova ferramenta para a tomada de decis&#227;o ap&#243;s a repara&#231;&#227;o cir&#250;rgica da Tetralogia de Fallot&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "F&#225;tima F&#46; Pinto"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "F&#225;tima F&#46;"
                "apellidos" => "Pinto"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204916302707"
          "doi" => "10.1016/j.repce.2016.12.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302707?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511630347X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003600000001/v2_201701040047/S087025511630347X/v2_201701040047/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204916302318"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.08.005"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "892"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2017;36:35-41"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2660
      "formatos" => array:3 [
        "EPUB" => 180
        "HTML" => 1972
        "PDF" => 508
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Do prices reflect the costs of cardiac surgery in the elderly&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "35"
          "paginaFinal" => "41"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1222
              "Ancho" => 2215
              "Tamanyo" => 169622
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Costs of cardiac surgery according to case-mix&#44; calculated costs&#44; and prices paid under the hospital&#39;s contract agreement&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pedro Coelho, Vanessa Rodrigues, Lu&#237;s Miranda, Jos&#233; Fragata, Pedro Pita Barros"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Coelho"
            ]
            1 => array:2 [
              "nombre" => "Vanessa"
              "apellidos" => "Rodrigues"
            ]
            2 => array:2 [
              "nombre" => "Lu&#237;s"
              "apellidos" => "Miranda"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Fragata"
            ]
            4 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Pita Barros"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255116302190"
        "doi" => "10.1016/j.repc.2016.08.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302190?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302318?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000001/v1_201701200114/S2174204916302318/v1_201701200114/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2174204916302690"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.12.004"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "914"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2017;36:21-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1919
      "formatos" => array:3 [
        "EPUB" => 134
        "HTML" => 1446
        "PDF" => 339
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Usefulness of right ventricular and right atrial two-dimensional speckle tracking strain to predict late arrhythmic events in adult patients with repaired Tetralogy of Fallot"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "21"
          "paginaFinal" => "29"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Utilidade do <span class="elsevierStyleItalic">strain</span> bidimensional por <span class="elsevierStyleItalic">speckle tracking</span> da aur&#237;cula e ventr&#237;culo direito para predizer arritmias tardias em doentes adultos com Tetralogia de Fallot corrigida"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 646
              "Ancho" => 1296
              "Tamanyo" => 84341
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Receiver operating characteristic curves of right atrial &#40;A&#41; and right ventricular &#40;B&#41; strain for the presence of documented arrhythmias in the subanalysis population &#40;n&#61;77&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana T&#46; Tim&#243;teo, Lu&#237;sa M&#46; Branco, S&#237;lvia A&#46; Rosa, Ruben Ramos, Ana F&#46; Agapito, L&#237;dia Sousa, Ana Galrinho, Jos&#233; A&#46; Oliveira, M&#225;rio M&#46; Oliveira, Rui C&#46; Ferreira"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Ana T&#46;"
              "apellidos" => "Tim&#243;teo"
            ]
            1 => array:2 [
              "nombre" => "Lu&#237;sa M&#46;"
              "apellidos" => "Branco"
            ]
            2 => array:2 [
              "nombre" => "S&#237;lvia A&#46;"
              "apellidos" => "Rosa"
            ]
            3 => array:2 [
              "nombre" => "Ruben"
              "apellidos" => "Ramos"
            ]
            4 => array:2 [
              "nombre" => "Ana F&#46;"
              "apellidos" => "Agapito"
            ]
            5 => array:2 [
              "nombre" => "L&#237;dia"
              "apellidos" => "Sousa"
            ]
            6 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Galrinho"
            ]
            7 => array:2 [
              "nombre" => "Jos&#233; A&#46;"
              "apellidos" => "Oliveira"
            ]
            8 => array:2 [
              "nombre" => "M&#225;rio M&#46;"
              "apellidos" => "Oliveira"
            ]
            9 => array:2 [
              "nombre" => "Rui C&#46;"
              "apellidos" => "Ferreira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255116303389"
        "doi" => "10.1016/j.repc.2016.07.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303389?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302690?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000001/v1_201701200114/S2174204916302690/v1_201701200114/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Right ventricular speckle tracking echocardiography&#58; A new tool for decision-making after surgical repair of tetralogy of Fallot&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "31"
        "paginaFinal" => "33"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "F&#225;tima F&#46; Pinto"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "F&#225;tima F&#46;"
            "apellidos" => "Pinto"
            "email" => array:1 [
              0 => "fatima&#46;pinto&#64;chlc&#46;min-saude&#46;pt"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servi&#231;o de Cardiologia Pedi&#225;trica&#44; Centro de Tratamento Integrado de Cardiopatias Cong&#233;nitas&#44; Hospital de Santa Marta&#44; Centro Hospitalar Lisboa Central&#44; EPE&#44; Lisboa&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Ecocardiografia de <span class="elsevierStyleItalic">speckle tracking</span> do ventr&#237;culo direito&#58; uma nova ferramenta para a tomada de decis&#227;o ap&#243;s a repara&#231;&#227;o cir&#250;rgica da Tetralogia de Fallot&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Surgical correction of tetralogy of Fallot &#40;TOF&#41; has evolved in recent years from correction after childhood to early surgery&#44; even in the neonatal period&#46; Before and after correction the right ventricle is mainly affected&#44; experiencing persistent pressure and&#47;or volume overload and intrinsic or acquired right ventricular &#40;RV&#41; myopathy&#46; On follow-up&#44; these patients can present RV enlargement&#44; dysfunction and fibrosis&#44; all with significant clinical impact&#44; such as exercise limitation&#44; RV failure and a substrate for lethal ventricular arrhythmias and sudden cardiac death &#40;SCD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a> A combination of varying degrees of long-standing pulmonary regurgitation and residual stenosis has been identified as a major issue after TOF correction that over time triggers RV remodeling&#44; affecting ventricular synchrony and coupling and also impairing left ventricular function&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In long-term follow-up&#44; arrhythmias are a common problem in more than 30&#37; of patients with repaired TOF&#44; sometimes causing adverse outcomes and even SCD&#44; which has an estimated incidence of 0&#46;2&#37; per year in these patients&#46; There is thus a need for accurate risk predictors in the follow-up of TOF patients&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a> Various clinical factors have been investigated as predictors of late arrhythmic events&#44; but they still lack strong positive predictive accuracy&#46; This situation has prompted considerable changes in the surgical approach to TOF in recent decades&#46; The current approach favors repair at a younger age &#40;&#60;2 years&#41;&#44; efforts to preserve pulmonary valve competence and to avoid ventriculotomy&#44; and extensive removal of infundibular muscle&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> Nevertheless&#44; definitive evidence on the optimal surgical strategies to protect RV function and reduce arrhythmias and risk of SCD is lacking&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">One of the hot topics in TOF is active long-term preservation of RV function&#46; Ways to prevent significant pulmonary regurgitation and to avoid RV dilatation remain the main target&#44; but the optimal timing for therapeutic intervention remains uncertain&#44; although there is a trend towards early reintervention and acceptance of certain approaches is emerging&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;7</span></a> Careful imaging surveillance of RV size and function is essential to determine optimal timing of additional corrective interventions&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">7</span></a> Which imaging parameters are the most reliable for decision-making in clinical assessment remains a crucial question&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Although there have been many advances in noninvasive RV imaging during the past decade&#44; echocardiography remains the most accessible and easiest method to assess anatomical anomalies and RV volumes and function during follow-up&#46; However&#44; this technique for assessing subclinical RV dysfunction has limited accuracy because of its inability to determine the geometric shape of the entire ventricle&#44; the load dependency of the measured parameters&#44; and the lack of specialized software for analyzing the right ventricle&#46; For these reasons cardiac magnetic resonance &#40;CMR&#41; is considered the gold-standard tool to assess RV anatomy and function in both acquired and congenital heart disease &#40;CHD&#41;&#44; when accuracy matters&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In 2010&#44; the American Society of Echocardiography developed guidelines for quantitative assessment of RV function in adults&#44; providing standardized measures for serial follow-up and aiming to improve the accuracy and reproducibility of echocardiographic imaging&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">9</span></a> Strain and strain rate measurements obtained by tissue Doppler imaging &#40;TDI&#41; and two-dimensional &#40;2D&#41; speckle-tracking echocardiography &#40;STE&#41; have emerged in the last decade as tools to assess RV myocardial deformation and to detect subclinical myocardial dysfunction in patients with normal conventional ventricular function indices&#44; and before RV ejection fraction decreases&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">9&#44;10</span></a> An increasing number of publications support 2D-STE as a primary modality for quantitative assessment of myocardial deformation in different clinical settings&#44; including repaired TOF&#46; Notwithstanding&#44; it is still a research tool and needs further validation and normative values in CHD patients before it can be integrated into everyday clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">10&#8211;13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Tim&#243;teo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> present a retrospective study assessing 2D-STE right atrial &#40;RA&#41; and RV peak systolic longitudinal strain and conventional echocardiographic parameters of RV function as predictors of arrhythmias in a cohort of adult patients with repaired TOF&#46; They compare data from two groups of TOF patients&#44; those with and without arrhythmic events&#44; in order to determine whether RV and&#47;or RA speckle tracking strain are associated with previous arrhythmic events&#46; They found that patients with arrhythmias were older&#44; surgical correction was performed later in life&#44; and RA and RV strain were significantly reduced&#46; Age at correction and the presence of residual defects were the only independent predictors for arrhythmias&#46; RA and RV strain measurements were significantly decreased&#44; but they failed to establish strain as an independent predictor for arrhythmias in the overall study group&#46; This was overcome by performing a subanalysis after excluding patients with a second surgical correction&#46; They conclude that strain measurements of the right heart may be useful for risk stratification of arrhythmias in patients with repaired tetralogy of Fallot&#44; although these data need to be supported by more extensive prospective data&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Overall&#44; the findings of this study corroborate a previous pilot study by the same group and are in line with other studies addressing tachyarrhythmia risk predictors in operated TOF patients&#46; Of note&#44; the studied patients with arrhythmias were older &#40;12 years older than those without arrhythmias&#41;&#44; and were operated later in life &#40;twice the age of those without arrhythmias&#41;&#44; reflecting the expected evolution of the disease in a longer follow-up and the use of older surgical strategies&#46; Additionally&#44; these patients may also present structural abnormalities of the RV myocardium&#44; such as fibrosis&#44; which can trigger RV dysfunction and arrhythmias&#46; Investigation of these anomalies using late enhancement CMR could add interesting data on the studied population&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The authors also studied RV function using conventional echocardiographic measurements and found that neither RV fractional area change nor tricuspid annular plane systolic excursion &#40;TAPSE&#41; predicted the presence of arrhythmias&#46; Both are simple routine measures of RV systolic function&#44; but they do not take into account the global geometry of the RV&#44; as the authors point out&#46; Three-dimensional &#40;3D&#41; echocardiography was expected to overcome some of these issues&#46; Dragulescu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a> demonstrated that 3D echocardiography provided more accurate measurements of RV function and a better correlation with CMR in repaired TOF patients&#46; They also showed that TAPSE was useful as an indicator of RV pressure and volume overload&#44; with a good correlation with RV ejection fraction on CMR&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a> Nevertheless&#44; 3D echocardiography is time-consuming and when image quality is suboptimal may lead to incomplete data sets&#44; as the technique requires specialized software and training&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">RV peak systolic longitudinal strain is an index of RV myocardial function&#44; but its measurement in clinical practice has been hampered by a lack of uniformity in software&#44; methods and reference values&#46; Recently&#44; a large study provided reference values and methods adjusted for demographics and gender in healthy subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a> These authors also demonstrated that LV and RA longitudinal strain were correlates of RV longitudinal strain&#44; suggesting that 2D-STE is able to assess the functional coupling of the right ventricle with the left ventricle and the right atrium&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a> In the present study&#44; the addition of LV longitudinal strain analysis could have shed light on the relationships governing ventricular coupling in these patients&#46; It would also be interesting to analyze the presence of RV dyssynchrony and its relation with arrhythmic events&#44; although Moon et al&#46; failed to demonstrate differences in ventricular dyssynchrony in TOF patients with decreased longitudinal strain of both ventricles&#44; which was associated with arrhythmic events&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The use of RV longitudinal strain as a parameter of systolic dysfunction in TOF patients should&#44; however&#44; be treated with caution&#44; because it only measures the shortening of the ventricle along the base-to-apex direction&#44; reflecting the contraction of longitudinal myocardial fibers&#46; Studies have demonstrated that RV ejection fraction depends on multiple mechanisms which include the movement of the RV free wall&#44; the involvement of the interventricular septum during contraction and the circumferential contraction of the right outflow tract&#44; each of which makes varying contributions under different conditions&#46; Repaired TOF patients with pulmonary regurgitation may present some degree of outflow tract obstruction or hypertrophy&#44; which causes RV myocardial remodeling that favors circumferential displacement of myocardial fibers&#44; and for this reason RV longitudinal strain lacks accuracy to measure global RV function&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Finally&#44; the study by Tim&#243;teo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> adds important evidence on the usefulness of 2D-STE-derived longitudinal strain as a superior marker of early myocardial dysfunction compared to conventional echocardiographic measurements of RV function&#46; However&#44; the importance of these changes in clinical practice and their value as predictors of late arrhythmic events in patients with repaired TOF are still to be determined&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Speckle tracking echocardiography is here to stay&#59; extending its use to CHD may enhance our understanding of long-term functional changes in these patients&#46; Our ability to predict deterioration of ventricular function in patients with repaired TOF&#44; as in other operated CHD patients&#44; remains limited&#44; since we still do not understand why RV function deteriorates in some patients while in apparently similar patients it remains stable&#46; There are likely to be unknown factors&#44; such as genetic phenotype&#44; that play critical roles in mediating deterioration of the disease&#44; and this requires further investigation&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:18 [
            0 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult congenital heart disease&#58; importance of the right ventricle"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;A&#46; Warnes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2009.06.048"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "54"
                        "paginaInicial" => "1903"
                        "paginaFinal" => "1910"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19909869"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of right ventricular volume overload on three-dimensional global left ventricular mechanical dyssynchrony after surgical repair of tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "X&#46;C&#46; Liang"
                            1 => "E&#46;W&#46; Cheung"
                            2 => "S&#46;J&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2008.07.062"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2008"
                        "volumen" => "102"
                        "paginaInicial" => "1731"
                        "paginaFinal" => "1736"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19064033"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Twenty-to-thirty-seven-year follow-up after repair for tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;A&#46; Norgaard"
                            1 => "P&#46; Lauridsen"
                            2 => "M&#46; Helvind"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "1999"
                        "volumen" => "16"
                        "paginaInicial" => "125"
                        "paginaFinal" => "130"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10485408"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contemporary patterns of management of tetralogy of Fallot&#58; data from the Society of Thoracic Surgeons Database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46;F&#46; Al Habib"
                            1 => "J&#46;P&#46; Jacobs"
                            2 => "C&#46; Mavroudis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2010.03.110"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2010"
                        "volumen" => "90"
                        "paginaInicial" => "813"
                        "paginaFinal" => "820"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20732501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term results after early primary repair of tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46;A&#46; Bacha"
                            1 => "A&#46;M&#46; Scheule"
                            2 => "D&#46; Zurakowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mtc.2001.115156"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg"
                        "fecha" => "2001"
                        "volumen" => "122"
                        "paginaInicial" => "154"
                        "paginaFinal" => "161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11436049"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for cardiac chamber quantification by echocardiography in adults&#58; an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;M&#46; Lang"
                            1 => "L&#46;P&#46; Badano"
                            2 => "V&#46; Mor-Avi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ehjci/jev014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J Cardiovasc Imaging"
                        "fecha" => "2015"
                        "volumen" => "16"
                        "paginaInicial" => "233"
                        "paginaFinal" => "270"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25712077"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging&#58; detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;A&#46; Davlouros"
                            1 => "P&#46;J&#46; Kilner"
                            2 => "T&#46;S&#46; Hornung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2002"
                        "volumen" => "40"
                        "paginaInicial" => "2044"
                        "paginaFinal" => "2052"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12475468"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is MRI the preferred method for evaluating right ventricular size and function in patients with congenital heart disease&#63; MRI is the preferred method for evaluating right ventricular size and function in patients with congenital heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Geva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCIMAGING.113.000553"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ Cardiovasc Imaging"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "190"
                        "paginaFinal" => "197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24449548"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the echocardiographic assessment of the right heart in adults&#58; a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography&#44; a registered branch of the European Society of Cardiology&#44; and the Canadian Society of Echocardiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46;G&#46; Rudski"
                            1 => "W&#46;W&#46; Lai"
                            2 => "J&#46; Afilalo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2010.05.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2010"
                        "volumen" => "23"
                        "paginaInicial" => "685"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20620859"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of tissue Doppler imaging to predict arrhythmic events in adults with repaired tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Ramos"
                            1 => "L&#46; Branco"
                            2 => "A&#46; Agapito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2010"
                        "volumen" => "29"
                        "paginaInicial" => "1145"
                        "paginaFinal" => "1161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21066968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is MRI the preferred method for evaluating right ventricular size and function in patients with congenital heart disease&#63; MRI is not the preferred method for evaluating right ventricular size and function in patients with congenital heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; DeFaria Yeh"
                            1 => "E&#46; Foster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCIMAGING.113.000395"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ Cardiovasc Imaging"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "198"
                        "paginaFinal" => "205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24449549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Speckle tracking echocardiography in pediatric and congenital heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Forsey"
                            1 => "M&#46;K&#46; Friedberg"
                            2 => "L&#46; Mertens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/echo.12131"
                      "Revista" => array:6 [
                        "tituloSerie" => "Echocardiography"
                        "fecha" => "2013"
                        "volumen" => "30"
                        "paginaInicial" => "447"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23551605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of surgical correction of tetralogy of Fallot on short-term right and left ventricular function as determined by 2-dimensional speckle tracking echocardiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "Y&#46; Li"
                            1 => "X&#46; Wang"
                            2 => "Q&#46; Lv"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2016"
                        "volumen" => "95"
                        "paginaInicial" => "e4426"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of right ventricular and right atrial two-dimensional speckle tracking strain to predict late arrhythmia events in adult patients with repaired tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;T&#46; Tim&#243;teo"
                            1 => "L&#46;M&#46; Branco"
                            2 => "R&#46; Ramos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2016.07.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2017"
                        "volumen" => "36"
                        "paginaInicial" => "21"
                        "paginaFinal" => "29"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27939278"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Echocardiographic assessment of right ventricular volumes after surgical repair of tetralogy of Fallot&#58; clinical validation of a new echocardiographic method"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Dragulescu"
                            1 => "L&#46; Grosse-Wortmann"
                            2 => "C&#46; Fackoury"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2011.08.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2011"
                        "volumen" => "24"
                        "paginaInicial" => "1191"
                        "paginaFinal" => "1198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21920701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sex- and method-specific reference values for right ventricular strain by 2-dimensional speckle-tracking echocardiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Muraru"
                            1 => "S&#46; Onciul"
                            2 => "D&#46; Peluso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCIMAGING.115.003866"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Cardiovasc Imaging"
                        "fecha" => "2016"
                        "volumen" => "9"
                        "paginaInicial" => "e003866"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26860970"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation of biventricular strain and dyssynchrony in repaired tetralogy of Fallot measured by cardiac magnetic resonance to death and sustained ventricular tachycardia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;J&#46; Moon"
                            1 => "N&#46; Choueiter"
                            2 => "T&#46; Geva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2014.12.024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2015"
                        "volumen" => "115"
                        "paginaInicial" => "676"
                        "paginaFinal" => "680"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25727084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contraction pattern of the systemic right ventricle shift from longitudinal to circumferential shortening and absent global ventricular torsion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Pettersen"
                            1 => "T&#46; Helle-Valle"
                            2 => "T&#46; Edvardsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2007.02.062"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2007"
                        "volumen" => "49"
                        "paginaInicial" => "2450"
                        "paginaFinal" => "2456"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17599609"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003600000001/v1_201701200114/S2174204916302707/v1_201701200114/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9917"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000001/v1_201701200114/S2174204916302707/v1_201701200114/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302707?idApp=UINPBA00004E"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial comment
Right ventricular speckle tracking echocardiography: A new tool for decision-making after surgical repair of tetralogy of Fallot?
Ecocardiografia de speckle tracking do ventrículo direito: uma nova ferramenta para a tomada de decisão após a reparação cirúrgica da Tetralogia de Fallot?
Fátima F. Pinto
Serviço de Cardiologia Pediátrica, Centro de Tratamento Integrado de Cardiopatias Congénitas, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, EPE, Lisboa, Portugal
Read
4822
Times
was read the article
1653
Total PDF
3169
Total HTML
Share statistics
 array:24 [
  "pii" => "S2174204916302707"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2016.12.005"
  "estado" => "S300"
  "fechaPublicacion" => "2017-01-01"
  "aid" => "920"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "dis"
  "cita" => "Rev Port Cardiol. 2017;36:31-3"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1832
    "formatos" => array:3 [
      "EPUB" => 186
      "HTML" => 1296
      "PDF" => 350
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S087025511630347X"
      "issn" => "08702551"
      "doi" => "10.1016/j.repc.2016.11.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-01-01"
      "aid" => "920"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "dis"
      "cita" => "Rev Port Cardiol. 2017;36:31-3"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 3023
        "formatos" => array:3 [
          "EPUB" => 208
          "HTML" => 2321
          "PDF" => 494
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
        "titulo" => "Right ventricular speckle tracking echocardiography&#58; A new tool for decision-making after surgical repair of tetralogy of Fallot&#63;"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "31"
            "paginaFinal" => "33"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "pt" => array:1 [
            "titulo" => "Ecocardiografia de <span class="elsevierStyleItalic">speckle tracking</span> do ventr&#237;culo direito&#58; uma nova ferramenta para a tomada de decis&#227;o ap&#243;s a repara&#231;&#227;o cir&#250;rgica da Tetralogia de Fallot&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "F&#225;tima F&#46; Pinto"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "F&#225;tima F&#46;"
                "apellidos" => "Pinto"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2174204916302707"
          "doi" => "10.1016/j.repce.2016.12.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302707?idApp=UINPBA00004E"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511630347X?idApp=UINPBA00004E"
      "url" => "/08702551/0000003600000001/v2_201701040047/S087025511630347X/v2_201701040047/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2174204916302318"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.08.005"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "892"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2017;36:35-41"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2660
      "formatos" => array:3 [
        "EPUB" => 180
        "HTML" => 1972
        "PDF" => 508
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Do prices reflect the costs of cardiac surgery in the elderly&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "35"
          "paginaFinal" => "41"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1222
              "Ancho" => 2215
              "Tamanyo" => 169622
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Costs of cardiac surgery according to case-mix&#44; calculated costs&#44; and prices paid under the hospital&#39;s contract agreement&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Pedro Coelho, Vanessa Rodrigues, Lu&#237;s Miranda, Jos&#233; Fragata, Pedro Pita Barros"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Coelho"
            ]
            1 => array:2 [
              "nombre" => "Vanessa"
              "apellidos" => "Rodrigues"
            ]
            2 => array:2 [
              "nombre" => "Lu&#237;s"
              "apellidos" => "Miranda"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Fragata"
            ]
            4 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Pita Barros"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255116302190"
        "doi" => "10.1016/j.repc.2016.08.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116302190?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302318?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000001/v1_201701200114/S2174204916302318/v1_201701200114/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2174204916302690"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2016.12.004"
    "estado" => "S300"
    "fechaPublicacion" => "2017-01-01"
    "aid" => "914"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2017;36:21-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1919
      "formatos" => array:3 [
        "EPUB" => 134
        "HTML" => 1446
        "PDF" => 339
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Usefulness of right ventricular and right atrial two-dimensional speckle tracking strain to predict late arrhythmic events in adult patients with repaired Tetralogy of Fallot"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "21"
          "paginaFinal" => "29"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Utilidade do <span class="elsevierStyleItalic">strain</span> bidimensional por <span class="elsevierStyleItalic">speckle tracking</span> da aur&#237;cula e ventr&#237;culo direito para predizer arritmias tardias em doentes adultos com Tetralogia de Fallot corrigida"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 646
              "Ancho" => 1296
              "Tamanyo" => 84341
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Receiver operating characteristic curves of right atrial &#40;A&#41; and right ventricular &#40;B&#41; strain for the presence of documented arrhythmias in the subanalysis population &#40;n&#61;77&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana T&#46; Tim&#243;teo, Lu&#237;sa M&#46; Branco, S&#237;lvia A&#46; Rosa, Ruben Ramos, Ana F&#46; Agapito, L&#237;dia Sousa, Ana Galrinho, Jos&#233; A&#46; Oliveira, M&#225;rio M&#46; Oliveira, Rui C&#46; Ferreira"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Ana T&#46;"
              "apellidos" => "Tim&#243;teo"
            ]
            1 => array:2 [
              "nombre" => "Lu&#237;sa M&#46;"
              "apellidos" => "Branco"
            ]
            2 => array:2 [
              "nombre" => "S&#237;lvia A&#46;"
              "apellidos" => "Rosa"
            ]
            3 => array:2 [
              "nombre" => "Ruben"
              "apellidos" => "Ramos"
            ]
            4 => array:2 [
              "nombre" => "Ana F&#46;"
              "apellidos" => "Agapito"
            ]
            5 => array:2 [
              "nombre" => "L&#237;dia"
              "apellidos" => "Sousa"
            ]
            6 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Galrinho"
            ]
            7 => array:2 [
              "nombre" => "Jos&#233; A&#46;"
              "apellidos" => "Oliveira"
            ]
            8 => array:2 [
              "nombre" => "M&#225;rio M&#46;"
              "apellidos" => "Oliveira"
            ]
            9 => array:2 [
              "nombre" => "Rui C&#46;"
              "apellidos" => "Ferreira"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0870255116303389"
        "doi" => "10.1016/j.repc.2016.07.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255116303389?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302690?idApp=UINPBA00004E"
    "url" => "/21742049/0000003600000001/v1_201701200114/S2174204916302690/v1_201701200114/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>"
    "titulo" => "Right ventricular speckle tracking echocardiography&#58; A new tool for decision-making after surgical repair of tetralogy of Fallot&#63;"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "31"
        "paginaFinal" => "33"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "F&#225;tima F&#46; Pinto"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "F&#225;tima F&#46;"
            "apellidos" => "Pinto"
            "email" => array:1 [
              0 => "fatima&#46;pinto&#64;chlc&#46;min-saude&#46;pt"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servi&#231;o de Cardiologia Pedi&#225;trica&#44; Centro de Tratamento Integrado de Cardiopatias Cong&#233;nitas&#44; Hospital de Santa Marta&#44; Centro Hospitalar Lisboa Central&#44; EPE&#44; Lisboa&#44; Portugal"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Ecocardiografia de <span class="elsevierStyleItalic">speckle tracking</span> do ventr&#237;culo direito&#58; uma nova ferramenta para a tomada de decis&#227;o ap&#243;s a repara&#231;&#227;o cir&#250;rgica da Tetralogia de Fallot&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Surgical correction of tetralogy of Fallot &#40;TOF&#41; has evolved in recent years from correction after childhood to early surgery&#44; even in the neonatal period&#46; Before and after correction the right ventricle is mainly affected&#44; experiencing persistent pressure and&#47;or volume overload and intrinsic or acquired right ventricular &#40;RV&#41; myopathy&#46; On follow-up&#44; these patients can present RV enlargement&#44; dysfunction and fibrosis&#44; all with significant clinical impact&#44; such as exercise limitation&#44; RV failure and a substrate for lethal ventricular arrhythmias and sudden cardiac death &#40;SCD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a> A combination of varying degrees of long-standing pulmonary regurgitation and residual stenosis has been identified as a major issue after TOF correction that over time triggers RV remodeling&#44; affecting ventricular synchrony and coupling and also impairing left ventricular function&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In long-term follow-up&#44; arrhythmias are a common problem in more than 30&#37; of patients with repaired TOF&#44; sometimes causing adverse outcomes and even SCD&#44; which has an estimated incidence of 0&#46;2&#37; per year in these patients&#46; There is thus a need for accurate risk predictors in the follow-up of TOF patients&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a> Various clinical factors have been investigated as predictors of late arrhythmic events&#44; but they still lack strong positive predictive accuracy&#46; This situation has prompted considerable changes in the surgical approach to TOF in recent decades&#46; The current approach favors repair at a younger age &#40;&#60;2 years&#41;&#44; efforts to preserve pulmonary valve competence and to avoid ventriculotomy&#44; and extensive removal of infundibular muscle&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> Nevertheless&#44; definitive evidence on the optimal surgical strategies to protect RV function and reduce arrhythmias and risk of SCD is lacking&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">One of the hot topics in TOF is active long-term preservation of RV function&#46; Ways to prevent significant pulmonary regurgitation and to avoid RV dilatation remain the main target&#44; but the optimal timing for therapeutic intervention remains uncertain&#44; although there is a trend towards early reintervention and acceptance of certain approaches is emerging&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">6&#44;7</span></a> Careful imaging surveillance of RV size and function is essential to determine optimal timing of additional corrective interventions&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">7</span></a> Which imaging parameters are the most reliable for decision-making in clinical assessment remains a crucial question&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Although there have been many advances in noninvasive RV imaging during the past decade&#44; echocardiography remains the most accessible and easiest method to assess anatomical anomalies and RV volumes and function during follow-up&#46; However&#44; this technique for assessing subclinical RV dysfunction has limited accuracy because of its inability to determine the geometric shape of the entire ventricle&#44; the load dependency of the measured parameters&#44; and the lack of specialized software for analyzing the right ventricle&#46; For these reasons cardiac magnetic resonance &#40;CMR&#41; is considered the gold-standard tool to assess RV anatomy and function in both acquired and congenital heart disease &#40;CHD&#41;&#44; when accuracy matters&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In 2010&#44; the American Society of Echocardiography developed guidelines for quantitative assessment of RV function in adults&#44; providing standardized measures for serial follow-up and aiming to improve the accuracy and reproducibility of echocardiographic imaging&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">9</span></a> Strain and strain rate measurements obtained by tissue Doppler imaging &#40;TDI&#41; and two-dimensional &#40;2D&#41; speckle-tracking echocardiography &#40;STE&#41; have emerged in the last decade as tools to assess RV myocardial deformation and to detect subclinical myocardial dysfunction in patients with normal conventional ventricular function indices&#44; and before RV ejection fraction decreases&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">9&#44;10</span></a> An increasing number of publications support 2D-STE as a primary modality for quantitative assessment of myocardial deformation in different clinical settings&#44; including repaired TOF&#46; Notwithstanding&#44; it is still a research tool and needs further validation and normative values in CHD patients before it can be integrated into everyday clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">10&#8211;13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Journal</span>&#44; Tim&#243;teo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> present a retrospective study assessing 2D-STE right atrial &#40;RA&#41; and RV peak systolic longitudinal strain and conventional echocardiographic parameters of RV function as predictors of arrhythmias in a cohort of adult patients with repaired TOF&#46; They compare data from two groups of TOF patients&#44; those with and without arrhythmic events&#44; in order to determine whether RV and&#47;or RA speckle tracking strain are associated with previous arrhythmic events&#46; They found that patients with arrhythmias were older&#44; surgical correction was performed later in life&#44; and RA and RV strain were significantly reduced&#46; Age at correction and the presence of residual defects were the only independent predictors for arrhythmias&#46; RA and RV strain measurements were significantly decreased&#44; but they failed to establish strain as an independent predictor for arrhythmias in the overall study group&#46; This was overcome by performing a subanalysis after excluding patients with a second surgical correction&#46; They conclude that strain measurements of the right heart may be useful for risk stratification of arrhythmias in patients with repaired tetralogy of Fallot&#44; although these data need to be supported by more extensive prospective data&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Overall&#44; the findings of this study corroborate a previous pilot study by the same group and are in line with other studies addressing tachyarrhythmia risk predictors in operated TOF patients&#46; Of note&#44; the studied patients with arrhythmias were older &#40;12 years older than those without arrhythmias&#41;&#44; and were operated later in life &#40;twice the age of those without arrhythmias&#41;&#44; reflecting the expected evolution of the disease in a longer follow-up and the use of older surgical strategies&#46; Additionally&#44; these patients may also present structural abnormalities of the RV myocardium&#44; such as fibrosis&#44; which can trigger RV dysfunction and arrhythmias&#46; Investigation of these anomalies using late enhancement CMR could add interesting data on the studied population&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The authors also studied RV function using conventional echocardiographic measurements and found that neither RV fractional area change nor tricuspid annular plane systolic excursion &#40;TAPSE&#41; predicted the presence of arrhythmias&#46; Both are simple routine measures of RV systolic function&#44; but they do not take into account the global geometry of the RV&#44; as the authors point out&#46; Three-dimensional &#40;3D&#41; echocardiography was expected to overcome some of these issues&#46; Dragulescu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a> demonstrated that 3D echocardiography provided more accurate measurements of RV function and a better correlation with CMR in repaired TOF patients&#46; They also showed that TAPSE was useful as an indicator of RV pressure and volume overload&#44; with a good correlation with RV ejection fraction on CMR&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a> Nevertheless&#44; 3D echocardiography is time-consuming and when image quality is suboptimal may lead to incomplete data sets&#44; as the technique requires specialized software and training&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">RV peak systolic longitudinal strain is an index of RV myocardial function&#44; but its measurement in clinical practice has been hampered by a lack of uniformity in software&#44; methods and reference values&#46; Recently&#44; a large study provided reference values and methods adjusted for demographics and gender in healthy subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a> These authors also demonstrated that LV and RA longitudinal strain were correlates of RV longitudinal strain&#44; suggesting that 2D-STE is able to assess the functional coupling of the right ventricle with the left ventricle and the right atrium&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a> In the present study&#44; the addition of LV longitudinal strain analysis could have shed light on the relationships governing ventricular coupling in these patients&#46; It would also be interesting to analyze the presence of RV dyssynchrony and its relation with arrhythmic events&#44; although Moon et al&#46; failed to demonstrate differences in ventricular dyssynchrony in TOF patients with decreased longitudinal strain of both ventricles&#44; which was associated with arrhythmic events&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The use of RV longitudinal strain as a parameter of systolic dysfunction in TOF patients should&#44; however&#44; be treated with caution&#44; because it only measures the shortening of the ventricle along the base-to-apex direction&#44; reflecting the contraction of longitudinal myocardial fibers&#46; Studies have demonstrated that RV ejection fraction depends on multiple mechanisms which include the movement of the RV free wall&#44; the involvement of the interventricular septum during contraction and the circumferential contraction of the right outflow tract&#44; each of which makes varying contributions under different conditions&#46; Repaired TOF patients with pulmonary regurgitation may present some degree of outflow tract obstruction or hypertrophy&#44; which causes RV myocardial remodeling that favors circumferential displacement of myocardial fibers&#44; and for this reason RV longitudinal strain lacks accuracy to measure global RV function&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Finally&#44; the study by Tim&#243;teo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> adds important evidence on the usefulness of 2D-STE-derived longitudinal strain as a superior marker of early myocardial dysfunction compared to conventional echocardiographic measurements of RV function&#46; However&#44; the importance of these changes in clinical practice and their value as predictors of late arrhythmic events in patients with repaired TOF are still to be determined&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Speckle tracking echocardiography is here to stay&#59; extending its use to CHD may enhance our understanding of long-term functional changes in these patients&#46; Our ability to predict deterioration of ventricular function in patients with repaired TOF&#44; as in other operated CHD patients&#44; remains limited&#44; since we still do not understand why RV function deteriorates in some patients while in apparently similar patients it remains stable&#46; There are likely to be unknown factors&#44; such as genetic phenotype&#44; that play critical roles in mediating deterioration of the disease&#44; and this requires further investigation&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0065" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of interest"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:18 [
            0 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult congenital heart disease&#58; importance of the right ventricle"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;A&#46; Warnes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2009.06.048"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "54"
                        "paginaInicial" => "1903"
                        "paginaFinal" => "1910"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19909869"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of right ventricular volume overload on three-dimensional global left ventricular mechanical dyssynchrony after surgical repair of tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "X&#46;C&#46; Liang"
                            1 => "E&#46;W&#46; Cheung"
                            2 => "S&#46;J&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2008.07.062"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2008"
                        "volumen" => "102"
                        "paginaInicial" => "1731"
                        "paginaFinal" => "1736"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19064033"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Twenty-to-thirty-seven-year follow-up after repair for tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;A&#46; Norgaard"
                            1 => "P&#46; Lauridsen"
                            2 => "M&#46; Helvind"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "1999"
                        "volumen" => "16"
                        "paginaInicial" => "125"
                        "paginaFinal" => "130"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10485408"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contemporary patterns of management of tetralogy of Fallot&#58; data from the Society of Thoracic Surgeons Database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46;F&#46; Al Habib"
                            1 => "J&#46;P&#46; Jacobs"
                            2 => "C&#46; Mavroudis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2010.03.110"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2010"
                        "volumen" => "90"
                        "paginaInicial" => "813"
                        "paginaFinal" => "820"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20732501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term results after early primary repair of tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46;A&#46; Bacha"
                            1 => "A&#46;M&#46; Scheule"
                            2 => "D&#46; Zurakowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mtc.2001.115156"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thorac Cardiovasc Surg"
                        "fecha" => "2001"
                        "volumen" => "122"
                        "paginaInicial" => "154"
                        "paginaFinal" => "161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11436049"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for cardiac chamber quantification by echocardiography in adults&#58; an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;M&#46; Lang"
                            1 => "L&#46;P&#46; Badano"
                            2 => "V&#46; Mor-Avi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ehjci/jev014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J Cardiovasc Imaging"
                        "fecha" => "2015"
                        "volumen" => "16"
                        "paginaInicial" => "233"
                        "paginaFinal" => "270"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25712077"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging&#58; detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;A&#46; Davlouros"
                            1 => "P&#46;J&#46; Kilner"
                            2 => "T&#46;S&#46; Hornung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2002"
                        "volumen" => "40"
                        "paginaInicial" => "2044"
                        "paginaFinal" => "2052"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12475468"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is MRI the preferred method for evaluating right ventricular size and function in patients with congenital heart disease&#63; MRI is the preferred method for evaluating right ventricular size and function in patients with congenital heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Geva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCIMAGING.113.000553"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ Cardiovasc Imaging"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "190"
                        "paginaFinal" => "197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24449548"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the echocardiographic assessment of the right heart in adults&#58; a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography&#44; a registered branch of the European Society of Cardiology&#44; and the Canadian Society of Echocardiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46;G&#46; Rudski"
                            1 => "W&#46;W&#46; Lai"
                            2 => "J&#46; Afilalo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2010.05.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2010"
                        "volumen" => "23"
                        "paginaInicial" => "685"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20620859"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of tissue Doppler imaging to predict arrhythmic events in adults with repaired tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Ramos"
                            1 => "L&#46; Branco"
                            2 => "A&#46; Agapito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2010"
                        "volumen" => "29"
                        "paginaInicial" => "1145"
                        "paginaFinal" => "1161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21066968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is MRI the preferred method for evaluating right ventricular size and function in patients with congenital heart disease&#63; MRI is not the preferred method for evaluating right ventricular size and function in patients with congenital heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; DeFaria Yeh"
                            1 => "E&#46; Foster"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCIMAGING.113.000395"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ Cardiovasc Imaging"
                        "fecha" => "2014"
                        "volumen" => "7"
                        "paginaInicial" => "198"
                        "paginaFinal" => "205"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24449549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Speckle tracking echocardiography in pediatric and congenital heart disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Forsey"
                            1 => "M&#46;K&#46; Friedberg"
                            2 => "L&#46; Mertens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/echo.12131"
                      "Revista" => array:6 [
                        "tituloSerie" => "Echocardiography"
                        "fecha" => "2013"
                        "volumen" => "30"
                        "paginaInicial" => "447"
                        "paginaFinal" => "459"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23551605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of surgical correction of tetralogy of Fallot on short-term right and left ventricular function as determined by 2-dimensional speckle tracking echocardiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "Y&#46; Li"
                            1 => "X&#46; Wang"
                            2 => "Q&#46; Lv"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2016"
                        "volumen" => "95"
                        "paginaInicial" => "e4426"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of right ventricular and right atrial two-dimensional speckle tracking strain to predict late arrhythmia events in adult patients with repaired tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;T&#46; Tim&#243;teo"
                            1 => "L&#46;M&#46; Branco"
                            2 => "R&#46; Ramos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2016.07.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2017"
                        "volumen" => "36"
                        "paginaInicial" => "21"
                        "paginaFinal" => "29"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27939278"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Echocardiographic assessment of right ventricular volumes after surgical repair of tetralogy of Fallot&#58; clinical validation of a new echocardiographic method"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Dragulescu"
                            1 => "L&#46; Grosse-Wortmann"
                            2 => "C&#46; Fackoury"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2011.08.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2011"
                        "volumen" => "24"
                        "paginaInicial" => "1191"
                        "paginaFinal" => "1198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21920701"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sex- and method-specific reference values for right ventricular strain by 2-dimensional speckle-tracking echocardiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Muraru"
                            1 => "S&#46; Onciul"
                            2 => "D&#46; Peluso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCIMAGING.115.003866"
                      "Revista" => array:5 [
                        "tituloSerie" => "Circ Cardiovasc Imaging"
                        "fecha" => "2016"
                        "volumen" => "9"
                        "paginaInicial" => "e003866"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26860970"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation of biventricular strain and dyssynchrony in repaired tetralogy of Fallot measured by cardiac magnetic resonance to death and sustained ventricular tachycardia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46;J&#46; Moon"
                            1 => "N&#46; Choueiter"
                            2 => "T&#46; Geva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2014.12.024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2015"
                        "volumen" => "115"
                        "paginaInicial" => "676"
                        "paginaFinal" => "680"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25727084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contraction pattern of the systemic right ventricle shift from longitudinal to circumferential shortening and absent global ventricular torsion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Pettersen"
                            1 => "T&#46; Helle-Valle"
                            2 => "T&#46; Edvardsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2007.02.062"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2007"
                        "volumen" => "49"
                        "paginaInicial" => "2450"
                        "paginaFinal" => "2456"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17599609"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003600000001/v1_201701200114/S2174204916302707/v1_201701200114/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9917"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000001/v1_201701200114/S2174204916302707/v1_201701200114/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302707?idApp=UINPBA00004E"
]
Article information
ISSN: 21742049
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 8 2 10
2024 October 50 30 80
2024 September 41 30 71
2024 August 38 29 67
2024 July 34 26 60
2024 June 34 30 64
2024 May 22 19 41
2024 April 40 26 66
2024 March 24 24 48
2024 February 31 22 53
2024 January 27 31 58
2023 December 28 33 61
2023 November 32 25 57
2023 October 31 12 43
2023 September 30 29 59
2023 August 36 15 51
2023 July 46 10 56
2023 June 26 12 38
2023 May 62 34 96
2023 April 35 6 41
2023 March 53 26 79
2023 February 41 26 67
2023 January 25 17 42
2022 December 51 22 73
2022 November 62 25 87
2022 October 37 20 57
2022 September 32 32 64
2022 August 37 35 72
2022 July 34 32 66
2022 June 29 25 54
2022 May 28 40 68
2022 April 29 18 47
2022 March 30 37 67
2022 February 21 29 50
2022 January 19 19 38
2021 December 17 27 44
2021 November 47 33 80
2021 October 31 46 77
2021 September 39 28 67
2021 August 22 36 58
2021 July 13 26 39
2021 June 24 28 52
2021 May 27 31 58
2021 April 27 48 75
2021 March 46 17 63
2021 February 48 11 59
2021 January 23 12 35
2020 December 28 6 34
2020 November 22 21 43
2020 October 17 10 27
2020 September 53 11 64
2020 August 17 13 30
2020 July 44 11 55
2020 June 32 7 39
2020 May 25 5 30
2020 April 23 6 29
2020 March 38 15 53
2020 February 30 42 72
2020 January 25 6 31
2019 December 23 3 26
2019 November 20 6 26
2019 October 45 4 49
2019 September 10 13 23
2019 August 23 7 30
2019 July 32 7 39
2019 June 17 11 28
2019 May 42 10 52
2019 April 8 11 19
2019 March 82 9 91
2019 February 96 8 104
2019 January 20 6 26
2018 December 28 11 39
2018 November 58 11 69
2018 October 56 13 69
2018 September 26 8 34
2018 August 22 10 32
2018 July 15 4 19
2018 June 32 8 40
2018 May 44 5 49
2018 April 48 2 50
2018 March 56 6 62
2018 February 27 3 30
2018 January 57 10 67
2017 December 82 2 84
2017 November 27 12 39
2017 October 23 9 32
2017 September 15 5 20
2017 August 21 8 29
2017 July 14 3 17
2017 June 24 11 35
2017 May 32 14 46
2017 April 10 6 16
2017 March 34 28 62
2017 February 57 16 73
2017 January 22 9 31
Show all

Follow this link to access the full text of the article

Idiomas
Revista Portuguesa de Cardiologia (English edition)
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

By checking that you are a health professional, you are stating that you are aware and accept that the Portuguese Journal of Cardiology (RPC) is the Data Controller that processes the personal information of users of its website, with its registered office at Campo Grande, n.º 28, 13.º, 1700-093 Lisbon, telephone 217 970 685 and 217 817 630, fax 217 931 095, and email revista@spc.pt. I declare for all purposes that the information provided herein is accurate and correct.