{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:49:27Z","timestamp":1792684167170,"version":"4.5.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Left ventricular (LV) dilatation is an important prognostic factor in patients with aortic regurgitation (AR). Although current guidelines recommend the use of LV end-systolic diameter index (LVESDi) to indicate the need for intervention, recent studies suggested that LV end-systolic volume index (LVESVi) may more accurately characterize LV remodelling.<\/jats:p>\n                  <jats:p>The present study aims to evaluate, in a multi-centre setting, whether combining LV linear and volumetric measures could improve risk stratification.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A total of 1070 patients (56 \u00b1 18 years, 65% male) with significant AR were included. Cut-off values of 20\u2005mm\/m2 for LVESDi and 45\u2005mL\/m2 for LVESVi were used to identify the following groups: no-significant LV dilatation (n = 485), when both LVESDi and LVESVi were below the cut-off values; discordant LV dilatation (n = 279) if only one positive criterium was present; and concordant LV dilatation (n = 306) when both LVESDi and LVESVi were enlarged. The primary endpoint was all-cause mortality. During a median follow-up of 7.4 (IQR, 4.5\u201311) years, 168 patients (16%) died, and 484 (45%) underwent aortic valve surgery (AVS). Patients with concordant LV dilatation showed the worst 10-year survival (P &amp;lt; 0.001). Discordant (HR 2.066, 95% CI 1.295\u20133.298; P = 0.002) or concordant LV dilatation (HR 2.759, 95% CI 1.616\u20134.710; P &amp;lt; 0.001) was independently associated with higher mortality compared with patients with no-significant LV dilatation after adjusting for relevant clinical and echocardiographic variables and regardless of AR severity. However, both groups showed greater benefit from AVS. LV dilatation, either concordant or discordant, was also independently associated with outcome in asymptomatic patients and those with left ventricular ejection fraction &amp;gt; 55%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with significant AR, the presence of LV dilatation detected by linear and\/or volumetric measures was independently associated with increased mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaf165","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T16:17:02Z","timestamp":1749140222000},"page":"1466-1474","source":"Crossref","is-referenced-by-count":7,"title":["Left ventricular dilatation in patients with significant aortic regurgitation: association with outcome"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2887-4159","authenticated-orcid":false,"given":"Pilar","family":"Lopez Santi","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, Leiden 2300 RC ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Bernard","sequence":"additional","affiliation":[{"name":"Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec-Universit\u00e9 Laval , Qu\u00e9bec ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6905-9439","authenticated-orcid":false,"given":"Federico","family":"Fortuni","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, Leiden 2300 RC ,","place":["The Netherlands"]},{"name":"Department of Cardiology, San Giovanni Battista Hospital , Foligno ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steele C","family":"Butcher","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, Leiden 2300 RC ,","place":["The Netherlands"]},{"name":"Department of Medicine Royal Perth Hospital Perth Western Australia ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Meucci","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, Leiden 2300 RC ,","place":["The Netherlands"]},{"name":"Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Sarrazyn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, Leiden 2300 RC ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aileen Paula","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, Leiden 2300 RC ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeru","family":"Nabeta","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , Albinusdreef 2, Leiden 2300 RC ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingnan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong , Hong Kong ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan A","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Medicine and Pharmacy \u2018Carol Davila\u2019, Euroecolab , Bucharest ,","place":["Rom\u00e2nia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar L W","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National University Heart Centre ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-3108","authenticated-orcid":false,"given":"Kai-Hang","family":"Yiu","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong , Hong Kong 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