Anne-Marie Koop

8 305 SUPPLEMENTAL METHODS Specification of categorization criteria of type and degree of loading Categorization and scoring was performed based on the combination of anatomical diagnosis, repair status and actual echocardiographic assessment. The degree of RV pressure overload was scored as none, mild-to-moderate or severe based on the estimated RV pressure either estimated by the maximumvelocity (Vmax) of a tricuspid regurgitation (mild-to-moderate <2.8 m/s and severe >2.8 m/s) or by Vmax over the pulmonary valve in children with sub- or supravalvular pulmonary stenosis (mild-to- moderate: 2-4 m/s; severe: >4 m/s). 1 In childrenwith PAH, the diagnosis had previously been confirmed by right heart catheterization or, in case of clinical instability, by echocardiography. 2 In childrenwith pulmonary regurgitation (PR) the degree of volume overload was scored based on the degree of PR, as determined by the magnitude/ extent, localization, and the vena contracta of the regurgitant jet. Mild-to-moderate PR was defined as a relatively broad jet originating in the main pulmonary artery just above valvular closure lines. Severe PR was defined as a voluminous diastolic retrograde jet originating from the branch pulmonary arteries. 3 In children with an ASD, the magnitude of the left-to-right shunt and thus RV volume overload was estimated by RV size on echocardiography and classified as mild-to-moderate or severe. Biomarker assays NT-proBNP was measured using the Elecsys (Roche, Basel, Switzerland) assay and galectin-3 with the Architect platform (Abbott, Chicago, United States). High sensitive Troponin T (hsTnT) was measured with Elecsys (Roche, Basel, Switzerland) in lithium heparin anticoagulated tubes. GDF-15 ( DGD150 , R&D Systems, Abingdon, United Kingdom), MR-proADM ( 82992 , Thermo Scientific Brahms, Henningsdorf, Germany), MPO ( DMYE00B , R&D Systems, Abingdon, United Kingdom), neprilysin ( EHMME , Thermo Scientific, Frederick, United States of America) and ET-1 ( DET100 , R&D Systems, Abingdon, United Kingdom) were determined in one badge using Kryptor or ELISA assays using EDTA plasma.