{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:48:04Z","timestamp":1772131684714,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,5,19]],"date-time":"2024-05-19T00:00:00Z","timestamp":1716076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data using real\u2010world assessments of aortic regurgitation (AR) severity to identify rates of Heart Valve Team evaluation and aortic valve replacement (AVR), as well as mortality among untreated patients, are lacking. The present study assessed these trends in care and outcomes for real\u2010world patients with documented AR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a deidentified data set (January 2018\u2013March 2023) representing 1,002,853 patients\u2009&gt;18 years of age from 25 US institutions participating in the egnite Database (egnite, Inc.) with appropriate permissions, patients were classified by AR severity in echocardiographic reports. Rates of evaluation by the Heart Valve Team, AVR, and all\u2010cause mortality without AVR were examined using Kaplan\u2013Meier estimates and compared using the log\u2010rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within the data set, 845,113 patients had AR severity documented. For moderate\u2010to\u2010severe or severe AR, respectively, 2\u2010year rates (95% confidence interval) of evaluation by the Heart Valve Team (43.5% [41.7%\u201345.3%] and 65.4% [63.3%\u201367.4%]) and AVR (19.4% [17.6%\u201321.1%] and 46.5% [44.2%\u201348.8%]) were low. Mortality at 2 years without AVR increased with greater AR severity, up to 20.7% for severe AR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In exploratory analyses, 2\u2010year mortality for untreated patients with left ventricular end\u2010systolic dimension index\u2009&gt;\u200925\u2009mm\/m<jats:sup>2<\/jats:sup> was similar for moderate (34.3% [29.2%\u201339.1%]) and severe (37.2% [24.9%\u201347.5%]) AR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Moderate or greater AR is associated with poor clinical outcomes among untreated patients at 2 years. Rates of Heart Valve Team evaluation and AVR were low for those with moderate or greater AR, suggesting that earlier referral to the Heart Valve Team could be beneficial.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31085","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T06:03:38Z","timestamp":1716185018000},"page":"145-154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical journey for patients with aortic regurgitation: A retrospective observational study from a multicenter database"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6785-6899","authenticated-orcid":false,"given":"Nicholas S.","family":"Amoroso","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8530-5035","authenticated-orcid":false,"given":"Rahul P.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Stanford University School of Medicine Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5507-3712","authenticated-orcid":false,"given":"Philippe","family":"G\u00e9n\u00e9reux","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Morristown Medical Center Morristown New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duane S.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston Massachusetts USA"},{"name":"JenaValve Technology, Inc. Irvine California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Dobbles","sequence":"additional","affiliation":[{"name":"egnite Inc. Aliso Viejo California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Kwon","sequence":"additional","affiliation":[{"name":"egnite Inc. Aliso Viejo California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinod H.","family":"Thourani","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Marcus Valve Center, Piedmont Heart Institute Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda D.","family":"Gillam","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Morristown Medical Center Morristown New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,19]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"e72","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines","volume":"143","author":"Otto CM","year":"2021","journal-title":"Circulation"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.839787"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/24748706.2021.1988779"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(03)00335-3"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.4.1625"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.15436"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2023.01.011"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.08.045"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00351-2"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/24748706.2018.1479078"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000031"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.024"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.09.796"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.112.975623"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.12.017"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jeq030"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90471-S"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.08.1058"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2023.02.009"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw229"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/2043-9113-4-12"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.03.027"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.04.026"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2022.100398"},{"key":"e_1_2_13_28_1","unstructured":"NathanA. 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