BACKGROUND: Long-term biventricular systolic performance is a key determinant of clinical outcomes late after @entity215 ( @entity215 ) repair. A need exists for early indices of both left ventricular (LV) and right ventricular (RV) compromise in this population. METHODS: Twenty-nine @entity1 (age range, 5-18  years) with repaired @entity215 and 44 healthy controls were prospectively evaluated. M-mode and tissue Doppler data were obtained for each ventricle and the RV outflow tract at rest and during semisupine bicycle exercise. By making measurements of myocardial acceleration during isovolumic contraction during exercise, at increasing heart rates, LV force-frequency curves were constructed. @entity1 also underwent cardiac magnetic resonance imaging, cardiopulmonary exercise testing, and measurement of serum neurohormonal markers. RESULTS: @entity1 with repaired @entity215 had dilated right ventricles (RV end-diastolic volume index  =  153      37.3  mL/m(2)) but normal ejection fractions as measured on magnetic resonance imaging (LV ejection fraction  = 59.3    6.2%, RV ejection fraction  = 50.2    8.5%) and normal serum neurohormonal markers. Detailed resting echocardiography detected abnormal ventricular function, worst in the right ventricle and RV outflow tract. Exercise exacerbated these findings and provoked significant decline in LV indices. The LV force-frequency curves of @entity1 were attenuated, with an early plateau and inadequate increase of isovolumic contraction. Correlations were seen between peak exercise LV isovolumic contraction and percentage predicted peak @entity26 uptake (r  =  0.51, P  =  .02), LV and RV ejection fractions (r  =  0.41, P  =  .03), and RV and LV long-axis fractional shortening (r  =  0.44, P  =  .02). CONCLUSIONS: The postsurgical pathophysiology of @entity215 begins early after repair. At a time when clinically well and while routine indices of heart function remain normal, @entity1 with repaired @entity215 exhibit @entity1001 and subtle, interlinked @entity854 on resting echocardiography. Exercise echocardiography provides additional information and reveals abnormal LV excitation-contractile coupling that may be linked to impaired exercise capacity.

Exercise Echocardiography Demonstrates Biventricular Systolic Dysfunction and Reveals Decreased Left Ventricular Contractile Reserve in XXXX After Tetralogy of Fallot Repair.

@entity1 :: ('9606', 'Species') :: ['children', 'Patients', 'patients', 'Children'] @entity215 :: ('MESH:D013771', 'Disease') :: ['TOF', 'tetralogy of Fallot'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity854 :: ('MESH:D018376', 'Disease') :: ['biventricular abnormalities'] @entity1001 :: ('MESH:C566255', 'Disease') :: ['RV dilatation']
@entity1 :: (9606,Species) :: ['Children']
