{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:58:46Z","timestamp":1789642726821,"version":"4.0.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Biomedical Research Centre at Barts"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Chronic degenerative mitral regurgitation leads to volume overload causing left ventricular (LV) enlargement and eventually LV impairment. Current guidelines determining thresholds for intervention are based on LV diameters and ejection fraction (LVEF). There are sparse data examining the value of LV volumes and newer markers of LV performance on outcomes of surgery in mitral valve prolapse. The aim of this study is to identify the best marker of LV impairment after mitral valve surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Prospective, observational study of patients with mitral valve prolapse undergoing mitral valve surgery. Pre-operative LV diameters, volumes, LVEF, global longitudinal strain (GLS), and myocardial work measured. Post-operative LV impairment defined as LVEF &amp;lt; 50% at 1 year post-surgery. Eighty-seven patients included. Thirteen percent developed post-operative LV impairment. Patients with post-operative LV dysfunction showed significantly larger indexed LV end-systolic diameters, indexed LV end-systolic volumes (LVESVi), lower LVEF, and more abnormal GLS than patients without post-operative LV dysfunction. In multivariate analysis, LVESVi [odds ratio 1.11 (95% CI 1.01\u20131.23), P = 0.039] and GLS [odds ratio 1.46 (95% CI 1.00\u20132.14), P = 0.054] were the only independent predictors of post-operative LV dysfunction. The optimal cut-off of 36.3 mL\/m2 for LVESVi had a sensitivity of 82% and specificity of 78% for detection of post-operative LV impairment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Post-operative LV impairment is common. Indexed LV volumes (36.3 mL\/m2) provided the best marker of post-operative LV impairment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead093","type":"journal-article","created":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T12:58:54Z","timestamp":1683205134000},"page":"1252-1257","source":"Crossref","is-referenced-by-count":12,"title":["Determinants of post-operative left ventricular dysfunction in degenerative mitral regurgitation"],"prefix":"10.1093","volume":"24","author":[{"given":"Aeshah M","family":"Althunayyan","sequence":"first","affiliation":[{"name":"Heart Valve Clinic & Echocardiography Laboratory, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, EC1A 7BE London, UK"},{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London , Charterhouse Square, London EC1M 6BQ , UK"},{"name":"Department of Cardiac Technology, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University , Dammam, Kingdom of Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahar","family":"Alborikan","sequence":"additional","affiliation":[{"name":"Heart Valve Clinic & Echocardiography Laboratory, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, EC1A 7BE London, UK"},{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London , Charterhouse Square, London EC1M 6BQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sveeta","family":"Badiani","sequence":"additional","affiliation":[{"name":"Heart Valve Clinic & Echocardiography Laboratory, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, EC1A 7BE London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kit","family":"Wong","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, St Bartholomew\u2019s Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Uppal","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, St Bartholomew\u2019s Hospital , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Patel","sequence":"additional","affiliation":[{"name":"Eastbourne District General Hospital , Eastbourne , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-5160","authenticated-orcid":false,"given":"Steffen E","family":"Petersen","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London , Charterhouse Square, London EC1M 6BQ , UK"},{"name":"Barts Heart Centre, St Bartholomew\u2019s Hospital, Barts Health NHS Trust , West Smithfield, EC1A 7BE London , UK"},{"name":"Health Data Research UK , Gibbs Building, 215 Euston Road, NW1 2BE London , UK"},{"name":"Alan Turing Institute , 96 Euston Road, NW1 2DB London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Heart Valve Clinic & Echocardiography Laboratory, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, EC1A 7BE London, UK"},{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London , Charterhouse Square, London EC1M 6BQ , UK"},{"name":"Institute of Cardiovascular Sciences, UCL, 62 Huntley Street, WC1E 6DD London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0234-5366","authenticated-orcid":false,"given":"Sanjeev","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Heart Valve Clinic & Echocardiography Laboratory, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, EC1A 7BE London, UK"},{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London , Charterhouse Square, London EC1M 6BQ , UK"},{"name":"Institute of Cardiovascular Sciences, UCL, 62 Huntley Street, WC1E 6DD London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,4]]},"reference":[{"key":"2023082310040459100_jead093-B1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1080\/14779072.2019.1553619","article-title":"Mitral valve prolapse","volume":"17","author":"Althunayyan","year":"2019","journal-title":"Expert Rev Cardiovasc Ther"},{"key":"2023082310040459100_jead093-B2","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":"2023082310040459100_jead093-B3","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1161\/01.CIR.31.3.374","article-title":"Myocardial function and left ventricular volumes in acquired valvular insufficiency","volume":"31","author":"Miller","year":"1965","journal-title":"Circulation"},{"key":"2023082310040459100_jead093-B4","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.1161\/CIRCULATIONAHA.107.755942","article-title":"Left ventricular response to mitral regurgitation: implications for management","volume":"118","author":"Gaasch","year":"2008","journal-title":"Circulation"},{"key":"2023082310040459100_jead093-B5","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/0735-1097(93)90840-W","article-title":"Impaired left ventricular contractile function in patients with long-term mitral regurgitation and normal ejection fraction","volume":"22","author":"Starling","year":"1993","journal-title":"J Am Coll Cardiol"},{"key":"2023082310040459100_jead093-B6","doi-asserted-by":"crossref","first-page":"2334","DOI":"10.1161\/CIRCULATIONAHA.111.073239","article-title":"Magnetic resonance imaging with 3-dimensional analysis of left ventricular remodeling in isolated mitral regurgitation: implications beyond dimensions","volume":"125","author":"Schiros","year":"2012","journal-title":"Circulation"},{"key":"2023082310040459100_jead093-B7","doi-asserted-by":"crossref","first-page":"2752","DOI":"10.1016\/j.jtcvs.2014.07.029","article-title":"Left ventricular dysfunction after mitral valve repair\u2013the fallacy of \u201cnormal\u201d preoperative myocardial function","volume":"148","author":"Quintana","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023082310040459100_jead093-B8","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1161\/01.CIR.90.2.830","article-title":"Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation","volume":"90","author":"Enriquez-Sarano","year":"1994","journal-title":"Circulation"},{"key":"2023082310040459100_jead093-B9","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/j.jcmg.2018.03.016","article-title":"Myocardial strain in prediction of outcomes after surgery for severe mitral regurgitation","volume":"11","author":"Kim","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023082310040459100_jead093-B10","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1093\/ehjci\/jes155","article-title":"Global longitudinal strain predicts left ventricular dysfunction after mitral valve repair","volume":"14","author":"Witkowski","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023082310040459100_jead093-B11","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/ehjci\/jey156","article-title":"Myocardial work by echocardiography: a novel method ready for clinical testing","author":"Boe","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2023082310040459100_jead093-B12","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.120.012142","article-title":"Prognostic implications of left ventricular myocardial work indices in patients with secondary mitral regurgitation","volume":"14","author":"Yedidya","year":"2021","journal-title":"Circ Cardiovasc Imaging"},{"key":"2023082310040459100_jead093-B13","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.echo.2020.05.010","article-title":"Myocardial work in nonobstructive hypertrophic cardiomyopathy: implications for outcome","volume":"33","author":"Hiemstra","year":"2020","journal-title":"J Am Soc Echocardiogr"},{"key":"2023082310040459100_jead093-B14","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-021-02474-y","article-title":"Prognostic value of myocardial work and global longitudinal strain in patients with heart failure and functional mitral regurgitation","author":"Verbeke","year":"2021","journal-title":"Int J Cardiovasc Imaging"},{"key":"2023082310040459100_jead093-B15","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1016\/S0735-1097(97)00329-X","article-title":"Echocardiographic assessment of left ventricualr remodelling: are left ventricular diameters suitable tools?","volume":"30","author":"Dujardin","year":"1997","journal-title":"J Am Coll Cardiol"},{"key":"2023082310040459100_jead093-B16","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1161\/01.CIR.91.4.1022","article-title":"Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis","volume":"91","author":"Enriquez-Sarano","year":"1995","journal-title":"Circulation"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/advance-article-pdf\/doi\/10.1093\/ehjci\/jead093\/50200028\/jead093.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/9\/1252\/51231245\/jead093.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/24\/9\/1252\/51231245\/jead093.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T10:06:04Z","timestamp":1692785164000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/24\/9\/1252\/7151543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,4]]},"references-count":16,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,5,4]]},"published-print":{"date-parts":[[2023,8,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jead093","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9]]},"published":{"date-parts":[[2023,5,4]]}}}