{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T23:40:49Z","timestamp":1792885249947,"version":"4.5.0"},"reference-count":25,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100012513","name":"CIBERCV","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012513","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Heart Failure"],"published-print":{"date-parts":[[2026,7]]},"DOI":"10.1016\/j.jchf.2026.103001","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T21:15:13Z","timestamp":1773090913000},"page":"103001","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["Secondary Mitral Regurgitation Trajectories and Prognosis With Intensification of Guideline-Directed Medical Therapy in Heart Failure"],"prefix":"10.1016","volume":"14","author":[{"given":"Cristina","family":"Ferrero","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-5711","authenticated-orcid":false,"given":"Pau","family":"Codina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Lup\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Ruiz-Cueto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Zamora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Borrellas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinta","family":"Llibre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Badia-Molins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Prencipe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Santiago-Vacas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2935-1272","authenticated-orcid":false,"given":"Mar","family":"Domingo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Santesmases","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ferrer-Sistach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Escabia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-8568","authenticated-orcid":false,"given":"Marco","family":"Metra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3416-8210","authenticated-orcid":false,"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9841-2737","authenticated-orcid":false,"given":"Victoria","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Bayes-Genis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"27","key":"10.1016\/j.jchf.2026.103001_bib1","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1093\/eurheartj\/ehz314","article-title":"Causes and mechanisms of isolated mitral regurgitation in the community: clinical context and outcome","volume":"40","author":"Dziadzko","year":"2019","journal-title":"Eur Heart J"},{"issue":"13","key":"10.1016\/j.jchf.2026.103001_bib2","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1093\/eurheartj\/ehab086","volume":"42","author":"Coats","year":"2021","journal-title":"Eur Heart J"},{"issue":"4","key":"10.1016\/j.jchf.2026.103001_bib3","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/j.1540-8191.2011.01274.x","article-title":"Respective prevalence of the different Carpentier classes of mitral regurgitation: a stepping stone for future therapeutic research and development","volume":"26","author":"De Marchena","year":"2011","journal-title":"J Card Surg"},{"issue":"3","key":"10.1016\/j.jchf.2026.103001_bib4","doi-asserted-by":"crossref","DOI":"10.1016\/j.shj.2022.100129","article-title":"Secondary mitral regurgitation: cardiac remodeling, diagnosis, and management","volume":"7","author":"Huang","year":"2022","journal-title":"Struct Heart"},{"issue":"10","key":"10.1016\/j.jchf.2026.103001_bib5","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1002\/ejhf.2276","article-title":"Impact of mitral regurgitation in patients with worsening heart failure: insights from BIOSTAT-CHF","volume":"23","author":"Pagnesi","year":"2021","journal-title":"Eur J Heart Fail"},{"issue":"1","key":"10.1016\/j.jchf.2026.103001_bib6","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/eurheartj\/ehx402","article-title":"Refining the prognostic impact of functional mitral regurgitation in chronic heart failure","volume":"39","author":"Goliasch","year":"2018","journal-title":"Eur Heart J"},{"issue":"1","key":"10.1016\/j.jchf.2026.103001_bib7","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ejhf.2333","volume":"24","author":"McDonagh","year":"2022","journal-title":"Eur J Heart Fail"},{"issue":"1","key":"10.1016\/j.jchf.2026.103001_bib8","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0041-1345(01)02717-8","article-title":"Effect of carvedilol therapy on functional mitral regurgitation, ventricular remodeling, and contractility in patients with heart failure due to left ventricular systolic dysfunction","volume":"34","author":"Comin-Colet","year":"2002","journal-title":"Transplant Proc"},{"issue":"4","key":"10.1016\/j.jchf.2026.103001_bib9","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1016\/S0002-8703(00)90036-X","article-title":"Beta-blockade therapy in chronic heart failure: diastolic function and mitral regurgitation improvement by carvedilol","volume":"139","author":"Capomolla","year":"2000","journal-title":"Am Heart J"},{"issue":"8","key":"10.1016\/j.jchf.2026.103001_bib10","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/S0002-9149(99)00059-4","article-title":"Effects of carvedilol on left ventricular mass, chamber geometry, and mitral regurgitation in chronic heart failure","volume":"83","author":"Lowes","year":"1999","journal-title":"Am J Cardiol"},{"issue":"7","key":"10.1016\/j.jchf.2026.103001_bib11","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1136\/hrt.2002.009696","article-title":"The impact of baseline left ventricular size and mitral regurgitation on reverse left ventricular remodelling in response to carvedilol: size doesn\u2019t matter","volume":"90","author":"Kotlyar","year":"2004","journal-title":"Heart"},{"issue":"11","key":"10.1016\/j.jchf.2026.103001_bib12","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1161\/CIRCULATIONAHA.118.037077","article-title":"Angiotensin receptor neprilysin inhibitor for functional mitral regurgitation","volume":"139","author":"Kang","year":"2019","journal-title":"Circulation"},{"issue":"24","key":"10.1016\/j.jchf.2026.103001_bib13","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1161\/CIRCULATIONAHA.124.069144","article-title":"Ertugliflozin for functional mitral regurgitation associated with heart failure: EFFORT trial","volume":"149","author":"Kang","year":"2024","journal-title":"Circulation"},{"issue":"7","key":"10.1016\/j.jchf.2026.103001_bib14","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1002\/ejhf.1862","article-title":"Pulmonary hypertension and right ventricular dysfunction in heart failure: prognosis and 15-year prospective longitudinal trajectories in survivors","volume":"22","author":"Santiago-Vacas","year":"2020","journal-title":"Eur J Heart Fail"},{"issue":"6","key":"10.1016\/j.jchf.2026.103001_bib15","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.jacc.2018.05.042","article-title":"Dynamic trajectories of left ventricular ejection fraction in heart failure","volume":"72","author":"Lup\u00f3n","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"7","key":"10.1016\/j.jchf.2026.103001_bib16","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"7","key":"10.1016\/j.jchf.2026.103001_bib17","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jchf.2026.103001_bib18","article-title":"Burden, treatment use, and outcome of secondary mitral regurgitation across the spectrum of heart failure: observational cohort study","volume":"373","author":"Bartko","year":"2021","journal-title":"BMJ"},{"issue":"1","key":"10.1016\/j.jchf.2026.103001_bib19","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.120.007944","article-title":"Myocardial tissue reverse remodeling after guideline-directed medical therapy in idiopathic dilated cardiomyopathy","volume":"14","author":"Xu","year":"2021","journal-title":"Circ Heart Fail"},{"issue":"6","key":"10.1016\/j.jchf.2026.103001_bib20","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1093\/ehjci\/jeac068","article-title":"Guideline directed medical therapy and reduction of secondary mitral regurgitation","volume":"23","author":"Spinka","year":"2022","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"9","key":"10.1016\/j.jchf.2026.103001_bib21","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1016\/j.jchf.2017.06.015","article-title":"Evolution of functional mitral regurgitation and prognosis in medically managed heart failure patients with reduced ejection fraction","volume":"5","author":"Nasser","year":"2017","journal-title":"JACC Heart Fail"},{"issue":"8","key":"10.1016\/j.jchf.2026.103001_bib22","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1007\/s00392-022-01991-7","article-title":"Clinical impact of changes in mitral regurgitation severity after medical therapy optimization in heart failure","volume":"111","author":"Pagnesi","year":"2022","journal-title":"Clin Res Cardiol"},{"issue":"24","key":"10.1016\/j.jchf.2026.103001_bib23","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1056\/NEJMoa1806640","article-title":"Transcatheter mitral-valve repair in patients with heart failure","volume":"379","author":"Stone","year":"2018","journal-title":"N Engl J Med"},{"issue":"24","key":"10.1016\/j.jchf.2026.103001_bib24","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1056\/NEJMoa1805374","article-title":"Percutaneous repair or medical treatment for secondary mitral regurgitation","volume":"379","author":"Obadia","year":"2018","journal-title":"N Engl J Med"},{"issue":"19","key":"10.1016\/j.jchf.2026.103001_bib25","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1056\/NEJMoa2314328","article-title":"Transcatheter valve repair in heart failure with moderate to severe mitral regurgitation","volume":"391","author":"Anker","year":"2024","journal-title":"N Engl J Med"}],"container-title":["JACC: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213177926001009?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213177926001009?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:29:15Z","timestamp":1785842955000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2213177926001009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["S2213177926001009"],"URL":"https:\/\/doi.org\/10.1016\/j.jchf.2026.103001","relation":{},"ISSN":["2213-1779"],"issn-type":[{"value":"2213-1779","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Secondary Mitral Regurgitation Trajectories and Prognosis With Intensification of Guideline-Directed Medical Therapy in Heart Failure","name":"articletitle","label":"Article Title"},{"value":"JACC: Heart Failure","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jchf.2026.103001","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 by the American College of Cardiology Foundation. Published by Elsevier.","name":"copyright","label":"Copyright"}],"article-number":"103001"}}