{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:21:57Z","timestamp":1790144517423,"version":"4.0.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"OCEAN Mitral registry"},{"name":"OCEAN SHD registry"},{"DOI":"10.13039\/100006520","name":"Edwards Lifesciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006520","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019341","name":"Medtronic Japan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016242","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016242","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Abbott Medical Japan"},{"DOI":"10.13039\/501100002336","name":"Daiichi Sankyo Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,9]]},"abstract":"Abstract<\/jats:title>\n \n Aims<\/jats:title>\n In patients with ventricular functional mitral regurgitation (VFMR) undergoing transcatheter edge-to-edge repair (M-TEER), the prognostic significance of the ratio between mitral regurgitant volume and left atrial volume (LAV) remains unclear. This ratio may reflect the proportional or disproportionate burden of regurgitation on the left atrium. To address this gap, we aimed to investigate the association between the regurgitant volume (RVol)\/LAV ratio and clinical outcomes in patients with VFMR, using data from a multicentre prospective registry.<\/jats:p>\n <\/jats:sec>\n \n Methods and results<\/jats:title>\n We calculated the RVol\/LAV ratio from baseline transthoracic echocardiograms. The median value of the RVol\/LAV ratio was 0.40. A total of 1830 patients who underwent M-TEER were allocated into two groups: the low RVol\/LAV (RVol\/LAV ratio &lt;0.40) and high RVol\/LAV (RVol\/LAV ratio \u22650.40) groups. The primary endpoint was heart failure hospitalization. Eight hundred eighty-eight and 942 patients were included into the low RVol\/LAV ratio and high RVol\/LAV ratio groups, respectively. The median follow-up period was 508 days. At 3 years after repair, 215 (37.6%) and 187 (32.1%) patients in the low RVol\/LAV and high RVol\/LAV groups, respectively, were hospitalized for heart failure. The patients in the low RVol\/LAV group demonstrated a significantly higher risk of heart failure hospitalization than did those in the high RVol\/LAV group (hazards ratio, 1.25; 95% confidence interval, 1.03\u20131.52; P = 0.022). Furthermore, using multivariable Cox regression analysis, the low RVol\/LAV was an independent predictor of the primary endpoint.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The RVol\/LAV ratio might serve as a valuable metric for improving risk stratification in patients with VFMR.<\/jats:p>\n <\/jats:sec>\n \n Clinical trials<\/jats:title>\n OCEAN Mitral registry (UMIN ID: UMIN000023653)<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjci\/jeaf304","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T13:08:45Z","timestamp":1762434525000},"page":"174-184","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic impact of regurgitant volume to left atrial volume ratio on ventricular functional mitral regurgitation"],"prefix":"10.1093","volume":"27","author":[{"given":"Masafumi","family":"Yoshikawa","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tokyo Women\u2019s Medical University , 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0976-1319","authenticated-orcid":false,"given":"Hisao","family":"Otsuki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Women\u2019s Medical University , 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2020-0792","authenticated-orcid":false,"given":"Takanori","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Women\u2019s Medical University , 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Shibahashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Women\u2019s Medical University , 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666 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