{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:23:46Z","timestamp":1790144626060,"version":"4.0.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T00:00:00Z","timestamp":1552435200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Functional mitral regurgitation (FMR) is a well-known pathophysiological factor in heart failure (HF) patients, and left atrial function (LAF) is a novel determinant of clinical status and outcome in this setting. However, little is known about the pathophysiological role of FMR on LAF in HFrEF patients. Aim of this study is to explore the possible interplay between the severity of FMR and LAF in heart failure with reduce ejection fraction (HFrEF) patients and their possible consequences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We studied 97 consecutive patients with FMR classified in two groups: mild-to-moderate MR ore less (FMR group, n = 38) and moderate-to-severe or more (SFMR group, n = 59). Using the phasic method, left atrial contractile, conduit, reservoir, and total emptying function (TLAEF) were calculated to assess LAF. SFMR group showed significantly lower values of LAF compared to FMR group. LA dysfunction (LA-dys) was defined for TLAEF values below the median and groups divided in four subgroups based on its presence. Patient with LA-Dys in SFMR group showed a worse clinical status, higher incidence of right ventricular dysfunction (RV-Dys), and pulmonary hypertension (PH), and a significant worse clinical survival compared to all other groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In our study, the survival was significantly lower in SFMR\/LA-Dys+ group. Furthermore, LA-Dys was strongly related with worse clinical status and higher incidence of PH and RV-Dys. These results suggest that in patients with SFMR and HFrEF, LA-Dys may represent both a marker of more advanced disease and a novel prognostic factor.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jez036","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T20:11:40Z","timestamp":1550607100000},"page":"1012-1019","source":"Crossref","is-referenced-by-count":12,"title":["Significant functional mitral regurgitation affects left atrial function in heart failure patients: haemodynamic correlations and prognostic implications"],"prefix":"10.1093","volume":"20","author":[{"given":"Giuseppe","family":"Palmiero","sequence":"first","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Melillo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Ferro","sequence":"additional","affiliation":[{"name":"Institute of Biostructure and Bioimaging, National Council of Research (CNR), Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Carlomagno","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Sordelli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Ascione","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Monda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Severino","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Ascione","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pio","family":"Caso","sequence":"additional","affiliation":[{"name":"Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,12]]},"reference":[{"key":"2019091011524666500_jez036-B1","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":". 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"2019091011524666500_jez036-B2","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1093\/eurheartj\/ehv510","article-title":"Beyond ejection fraction: an integrative approach for assessment of cardiac structure and function in heart failure","volume":"37","author":"Cikes","year":"2016","journal-title":"Eur Heart J"},{"key":"2019091011524666500_jez036-B3","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/S0002-9149(02)03172-7","article-title":"Prevalence and severity of mitral regurgitation in chronic systolic heart failure","volume":"91","author":"Robbins","year":"2003","journal-title":"Am J Cardiol"},{"key":"2019091011524666500_jez036-B4","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1093\/eurjhf\/hfq014","article-title":"Prognostic implications of functional mitral regurgitation according to the severity of the underlying chronic heart failure: a long-term outcome study","volume":"12","author":"Bursi","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"2019091011524666500_jez036-B5","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1136\/hrt.2011.225789","article-title":"Independent prognostic value of functional mitral regurgitation in patients with heart failure. 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Independent relationship of left atrial size and mortality in patients with heart failure: an individual patients meta-analysis of longitudinal data (MeRGE Heart Failure)","volume":"11","author":"Rossi","year":"2009","journal-title":"Eur J Heart Fail"},{"key":"2019091011524666500_jez036-B35","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1093\/eurheartj\/ehu405","article-title":"Left atrial function measured by cardiac magnetic resonance imaging in patients with heart failure: clinical associations and prognostic value","volume":"36","author":"Pellicori","year":"2015","journal-title":"Eur Heart J"},{"key":"2019091011524666500_jez036-B36","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/ehjci\/jew196","article-title":"Left atrial function index predicts long-term survival in stable outpatients with systolic heart failure","volume":"18","author":"Sargento","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/20\/9\/1012\/29189996\/jez036.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T16:22:51Z","timestamp":1568132571000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/20\/9\/1012\/5377346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,12]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,3,12]]},"published-print":{"date-parts":[[2019,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jez036","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,9]]},"published":{"date-parts":[[2019,3,12]]}}}