{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:21:43Z","timestamp":1790144503828,"version":"4.0.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000860","name":"European Society of Cardiology","doi-asserted-by":"crossref","award":["App000064741"],"award-info":[{"award-number":["App000064741"]}],"id":[{"id":"10.13039\/501100000860","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000860","name":"European Society of Cardiology","doi-asserted-by":"crossref","award":["R-2018-181220"],"award-info":[{"award-number":["R-2018-181220"]}],"id":[{"id":"10.13039\/501100000860","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,21]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Left atrial (LA) function is a strong prognostic marker in patients with heart failure and functional mitral regurgitation (MR). Although cardiac resynchronization therapy (CRT) has shown to improve MR severity, the interaction between a reduction in MR severity and an increase in LA function, as well as its association with outcomes, has not been investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>LA reservoir strain (RS) was evaluated with speckle tracking echocardiography in patients with at least moderate functional MR undergoing CRT implantation. MR improvement was defined as at least 1 grade improvement in MR severity at 6 months after CRT implantation. The primary endpoint was all-cause mortality. A total of 340 patients (mean age 66 \u00b1 10 years, 73% male) were included, of whom 200 (59%) showed MR improvement at 6 months follow-up. On multivariable analysis, an improvement in MR severity was independently associated with an increase in LARS (odds ratio 1.008; 95% confidence interval 1.003\u20131.013; P = 0.002). After multivariable adjustment, including baseline and follow-up variables, an increase in LARS was significantly associated with lower mortality. MR improvers showing LARS increasement had the lowest mortality rate, whereas outcomes were not significantly different between MR non-improvers and MR improvers showing no LARS increasement (P = 0.236).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A significant reduction in MR severity at 6 months after CRT implantation is independently associated with an increase in LARS. In addition, an increase in LARS is independently associated with lower all-cause mortality in patients with heart failure and significant functional MR.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjci\/jeac149","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T14:03:05Z","timestamp":1659016985000},"page":"532-541","source":"Crossref","is-referenced-by-count":8,"title":["Interaction between secondary mitral regurgitation and left atrial function and their prognostic implications after cardiac resynchronization therapy"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-5498","authenticated-orcid":false,"given":"Jan","family":"Stassen","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2300 RC Leiden , The Netherlands"},{"name":"Department of Cardiology, Jessa Hospital , Stadsomvaart 11, 3500 Hasselt , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6294-7668","authenticated-orcid":false,"given":"Xavier","family":"Galloo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2300 RC Leiden , The Netherlands"},{"name":"Department of Cardiology, Universitair Ziekenhuis Brussel , Laarbeeklaan 101, 1090 Brussels , Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3812-9825","authenticated-orcid":false,"given":"Kensuke","family":"Hirasawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2300 RC Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1693-7968","authenticated-orcid":false,"given":"Pieter","family":"van der Bijl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2300 RC Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin B","family":"Leon","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Columbia University Irving Medical Center\/Presbyterian Hospital and Cardiovascular Research Foundation , New York, NY 10032 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina Ajmone","family":"Marsan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2300 RC Leiden , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen J","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, 2300 RC Leiden , The Netherlands"},{"name":"Turku Heart Center, 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