{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:06:55Z","timestamp":1770743215276,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left ventricular end\u2010systolic diameter (LVESD) and ejection fraction (LVEF) are the parameters to look for when discussing repair in asymptomatic patients with a primary mitral regurgitation (PMR). Loading conditions are altering LV\u2010function quantification. LV\u2010myocardial work (LVMW) is a method based on pressure\u2010strain loops.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>We sought to evaluate the additive value of the LVMW for predicting clinical events in patients with PMR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>103 patients (66% men, median age 57 years) with asymptomatic severe PMR were explored at rest and during an exercise stress echocardiography. LV myocardial global work index (GWI), constructive work (GCW), wasted work (GWW), and work efficiency (GWE) were measured with speckle\u2010tracking echocardiography at rest and low workload. The indication for surgery was based on the heart teams' decision. The median follow\u2010up was 670 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinical events occurred for 50 patients (48.5%) with a median of event\u2010free survival distribution of 289 days. Systolic pulmonary artery pressure (sPAP) at rest was 32.61\u2009\u00b1\u20098.56\u2009mmHg and did not predict the risk of event like LVEF and LVESD. Changes in, GLS (hazard ratio [HR] 0.55; 95% confidence interval (Cl): 0.36\u20130.83; <jats:italic>p<\/jats:italic>\u2009=\u2009.005), GWI (HR 1.01; 95% Cl: 1.00\u20131.02; <jats:italic>p<\/jats:italic>\u2009=\u2009.002) and GCW (HR 1.85; 95% Cl: 1.28\u20132.68; <jats:italic>p<\/jats:italic>\u2009=\u2009.001) in addition to Left Atrial Volume Index (HR 1.73; 95% CI: 1.28 \u2013 2.33; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090,001) were independent predictors of events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Changes in myocardial work indices related to low\u2010dose exercise are relevant to best predict PMR patient prognosis It might help to better select patient's candidate for \u201cearly\u2010surgery.\u201d<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24190","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T11:43:35Z","timestamp":1699616615000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Primary mitral regurgitation: Toward a better quantification on left ventricular consequences"],"prefix":"10.1002","volume":"47","author":[{"given":"Antoine","family":"Neveu","sequence":"first","affiliation":[{"name":"CHU Rennes, Inserm, LTSI \u2013 UMR 1099 University of Rennes Rennes France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samy","family":"Aghezzaf","sequence":"additional","affiliation":[{"name":"Inserm, CHU Lille, Institut Pasteur de Lille, U1011 \u2010 EGID University of Lille Lille 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