SynthesisJournal of the American Heart Association2022
End-Diastolic Forward Flow and Restrictive Physiology in Repaired Tetralogy of Fallot: A Systematic Review and Meta-Analysis.
Synthesis in Journal of the American Heart Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- End-Diastolic Forward Flow Through the Pulmonic Valve in Carcinoid Heart Disease.JACC. Case reports · 2026Article
- Long-Term Effects of Right Ventricular Pressure and Volume Overload: A Comparative Analysis in an Ovine Model.Journal of clinical medicine · 2026Article
- End-diastolic forward flow (EDFF) after tetralogy of Fallot repair: Evolution of its role in management and prognosis.International journal of cardiology. Congenital heart disease · 2026Review
- MRI predictors of diastolic dysfunction and right ventricle end diastolic pressure in repaired tetralogy of Fallot.Pediatric cardiology · 2026Article
- From repair to right heart failure: Understanding the evolving landscape in tetralogy of fallot.Heart failure reviews · 2025Review
- Echocardiographic Evaluation of Pulmonary Hypertension: A Contemporary Review of the American Society of Echocardiography (ASE) Guidelines and Emerging Modalities.Current cardiology reports · 2025Review
- Addressing Diastolic Dysfunction in the Congenital Heart Population.Current cardiology reports · 2025Review
- Retrospective Evaluation of End-Diastolic Forward Flow and Restrictive Physiology in One Hundred and Sixty-Four Dogs with Pulmonary Stenosis.Veterinary sciences · 2025Article
- Accuracy of Intraoperative Transesophageal Echocardiographic Doppler Parameters in Assessing the Right Ventricular Diastolic Function After Repair of Tetralogy of Fallot in Pediatric Patients.Annals of cardiac anaesthesia · 2025Observational
- Right Ventricular Restrictive Physiology Is Associated With Right Ventricular Direct Flow From 4D Flow CMR.JACC. Asia · 2024Article
- Diastolic Right Ventricle Dysfunction in Repaired Tetralogy of Fallot: Is it Time for 4D-Flow-MRI Parameters?JACC. Asia · 2024Article
- Assessment of right ventricular diastolic function in pediatric patients with repaired tetralogy of Fallot by cardiovascular magnetic resonance and echocardiography.European radiology · 2024Article
- Use of Cardiovascular Magnetic Resonance for Risk Stratification in Repaired Tetralogy of Fallot.CJC pediatric and congenital heart disease · 2023Review
- Multimodality Imaging Assessment of Tetralogy of Fallot: From Diagnosis to Long-Term Follow-Up.Children (Basel, Switzerland) · 2023Review
- Association of cardiovascular magnetic resonance diastolic indices with arrhythmia in repaired Tetralogy of Fallot.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2023Article
- The right ventricle in tetralogy of Fallot: adaptation to sequential loading.Frontiers in pediatrics · 2023Review
- Echocardiographic Assessment of Right Ventricular Function in Paediatric Heart Disease: A Practical Clinical Approach.CJC pediatric and congenital heart disease · 2022Review
- End-diastolic forward flow in repaired tetralogy of Fallot: Mid-term outcomes from a single center.Frontiers in cardiovascular medicine · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Pulmonary arterial end-diastolic forward flow (EDFF) following repaired tetralogy of Fallot has been thought to represent right ventricular (RV) restrictive physiology, but is not fully understood. This systematic review and meta-analysis sought to clarify its physiological and clinical correlates, and to define a framework for understanding EDFF and RV restrictive physiology. Methods and Results PubMed/MEDLINE, Embase, Scopus, and reference lists of relevant articles were searched for observational studies published before March 2021. Random-effects meta-analysis was performed to identify factors associated with EDFF. Forty-two individual studies published between 1995 and 2021, including a total of 2651 participants (1132 with EDFF; 1519 with no EDFF), met eligibility criteria. The pooled estimated prevalence of EDFF among patients with repaired tetralogy of Fallot was 46.5% (95% CI, 41.6%-51.3%). Among patients with EDFF, the use of a transannular patch was significantly more common, and their stay in the intensive care unit was longer. EDFF was associated with greater RV indexed volumes and mass, as well as smaller E-wave velocity at the tricuspid valve. Finally, pulmonary regurgitation fraction was greater in patients with EDFF, and moderate to severe pulmonary regurgitation was more common in this population. Conclusions EDFF is associated with dilated, hypertrophied RVs and longstanding pulmonary regurgitation. Although several studies have defined RV restrictive physiology as the presence of EDFF, our study found no clear indicators of poor RV compliance in patients with EDFF, suggesting that EDFF may have multiple causes and might not be the precise equivalent of RV restrictive physiology.
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