{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:58:57Z","timestamp":1793019537513,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Pressure overload in aortic stenosis (AS) and both pressure and volume overload in aortic regurgitation (AR) induce concentric and eccentric hypertrophy, respectively. These structural changes influence left ventricular (LV) mechanics, but little is known about the time course of LV remodelling and mechanics after aortic valve surgery (AVR) and its differences in AS vs. AR. The present study aimed to characterize the time course of LV mass index (LVMI) and LV mechanics [by LV global longitudinal strain (LV GLS)] after AVR in AS vs. AR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Two hundred and eleven (61\u2009\u00b1\u200914\u2009years, 61% male) patients with severe AS (63%) or AR (37%) undergoing surgical AVR with routine echocardiographic follow-up at 1, 2, and\/or 5\u2009years were evaluated. Before AVR, LVMI was larger in AR patients compared with AS. Both groups showed moderately impaired LV GLS, but preserved LV ejection fraction. After surgery, both groups showed LV mass regression, although a more pronounced decline was seen in AR patients. Improvement in LV GLS was observed in both groups, but characterized by an initial decline in AR patients while LV GLS in AS patients remained initially stable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In severe AS and AR patients undergoing AVR, LV mass regression and changes in LV GLS are similar despite different LV remodelling before AVR. In AR, relief of volume overload led to reduction in LVMI and an initial decline in LV GLS. In contrast, relief of pressure overload in AS was characterized by a stable LV GLS and more sustained LV mass regression.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jez049","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T20:37:25Z","timestamp":1553027845000},"page":"1105-1111","source":"Crossref","is-referenced-by-count":44,"title":["Time course of left ventricular remodelling and mechanics after aortic valve surgery: aortic stenosis vs. aortic regurgitation"],"prefix":"10.1093","volume":"20","author":[{"given":"E Mara","family":"Vollema","sequence":"first","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurpreet K","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgard A","family":"Prihadi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"},{"name":"Department of Cardiology, Antwerp Cardiovascular Center, ZNA Middelheim, Lindendreef 1, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelien V","family":"Regeer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"See Hooi","family":"Ewe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, 5 Hospital Drive, Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold C T","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Princess Alexandra Hospital, University of Queensland, 199 Ipswich Rd, Woolloongabba QLD, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart J A","family":"Mertens","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J M","family":"Klautz","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Ajmone Marsan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA 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, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,1]]},"reference":[{"key":"2019092004513058400_jez049-B1","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1016\/j.jacc.2014.02.536","article-title":"2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"63","author":"Nishimura","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2019092004513058400_jez049-B2","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J"},{"key":"2019092004513058400_jez049-B3","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1161\/01.CIR.79.4.744","article-title":"Left ventricular myocardial structure in aortic valve disease before, intermediate, and late after aortic valve replacement","volume":"79","author":"Krayenbuehl","year":"1989","journal-title":"Circulation"},{"key":"2019092004513058400_jez049-B4","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jacc.2009.12.074","article-title":"Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease","volume":"56","author":"Azevedo","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2019092004513058400_jez049-B5","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1016\/j.jcmg.2016.10.007","article-title":"Myocardial fibrosis and cardiac decompensation in aortic stenosis","volume":"10","author":"Chin","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B6","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1161\/CIRCULATIONAHA.108.847772","article-title":"Impact of myocardial fibrosis in patients with symptomatic severe aortic stenosis","volume":"120","author":"Weidemann","year":"2009","journal-title":"Circulation"},{"key":"2019092004513058400_jez049-B7","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1136\/hrt.2009.190942","article-title":"Risk stratification in asymptomatic moderate to severe aortic stenosis: the importance of the valvular, arterial and ventricular interplay","volume":"96","author":"Lancellotti","year":"2010","journal-title":"Heart"},{"key":"2019092004513058400_jez049-B8","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1161\/CIRCIMAGING.112.977348","article-title":"Association of myocardial deformation with outcome in asymptomatic aortic stenosis with normal ejection fraction","volume":"5","author":"Yingchoncharoen","year":"2012","journal-title":"Circ Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B9","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1093\/eurheartj\/ehr084","article-title":"Alterations in multidirectional myocardial functions in patients with aortic stenosis and preserved ejection fraction: a two-dimensional speckle tracking analysis","volume":"32","author":"Ng","year":"2011","journal-title":"Eur Heart J"},{"key":"2019092004513058400_jez049-B10","first-page":"992","article-title":"Detection of subtle left ventricular systolic dysfunction in patients with significant aortic regurgitation and preserved left ventricular ejection fraction: speckle tracking echocardiographic analysis","volume":"16","author":"Ewe","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B11","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.jcmg.2017.02.016","article-title":"Incremental prognostic utility of left ventricular global longitudinal strain in asymptomatic patients with significant chronic aortic regurgitation and preserved left ventricular ejection fraction","volume":"11","author":"Alashi","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B12","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1093\/ehjci\/jes115","article-title":"Global longitudinal strain is a strong independent predictor of all-cause mortality in patients with aortic stenosis","volume":"13","author":"Kearney","year":"2012","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B13","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B14","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1093\/ehjci\/jew335","article-title":"Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography","volume":"18","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B15","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B16","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1161\/01.CIR.82.3.1051","article-title":"Aortic regurgitation. A lesion with similarities to both aortic stenosis and mitral regurgitation","volume":"82","author":"Carabello","year":"1990","journal-title":"Circulation"},{"key":"2019092004513058400_jez049-B17","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1161\/01.CIR.77.6.1345","article-title":"Time course of regression of left ventricular hypertrophy after aortic valve replacement","volume":"77","author":"Monrad","year":"1988","journal-title":"Circulation"},{"key":"2019092004513058400_jez049-B18","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1016\/0735-1097(93)90595-R","article-title":"Left ventricular hypertrophy and mortality after aortic valve replacement for aortic stenosis. A high risk subgroup identified by preoperative relative wall thickness","volume":"22","author":"Orsinelli","year":"1993","journal-title":"J Am Coll Cardiol"},{"key":"2019092004513058400_jez049-B19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1136\/hrt.2010.192997","article-title":"Prognostic effect of inappropriately high left ventricular mass in asymptomatic severe aortic stenosis","volume":"97","author":"Cioffi","year":"2011","journal-title":"Heart"},{"key":"2019092004513058400_jez049-B20","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1093\/ehjci\/jew288","article-title":"Impact of left ventricular remodelling patterns on outcomes in patients with aortic stenosis","volume":"18","author":"Capoulade","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B21","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.athoracsur.2008.12.086","article-title":"Indexed left ventricular dimensions best predict survival after aortic valve replacement in patients with aortic valve regurgitation","volume":"87","author":"Brown","year":"2009","journal-title":"Ann Thorac Surg"},{"key":"2019092004513058400_jez049-B22","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.athoracsur.2016.09.004","article-title":"Impact of left ventricular systolic function on outcome of correction of chronic severe aortic valve regurgitation: implications for timing of surgical intervention","volume":"103","author":"Murashita","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2019092004513058400_jez049-B23","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.jtcvs.2010.08.084","article-title":"Enhanced left ventricular mass regression after aortic valve replacement in patients with aortic stenosis is associated with improved long-term survival","volume":"142","author":"Ali","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2019092004513058400_jez049-B24","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.ahj.2014.04.015","article-title":"A critical review of hemodynamic changes and left ventricular remodeling after surgical aortic valve replacement and percutaneous aortic valve replacement","volume":"168","author":"Kim","year":"2014","journal-title":"Am Heart J"},{"key":"2019092004513058400_jez049-B25","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/ehjci\/jew321","article-title":"Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses","volume":"19","author":"Ngo","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B26","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jcmg.2016.11.004","article-title":"Long-term valve performance of TAVR and SAVR: a report from the PARTNER I Trial","volume":"10","author":"Daubert","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B27","doi-asserted-by":"crossref","first-page":"388","DOI":"10.5761\/atcs.oa.14-00295","article-title":"Long term results and predictors of left ventricular function recovery after aortic valve replacement for chronic aortic regurgitation","volume":"21","author":"Saisho","year":"2015","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"2019092004513058400_jez049-B28","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1161\/CIRCULATIONAHA.115.015371","article-title":"Clinical impact of changes in left ventricular function after aortic valve replacement: analysis from 3112 patients","volume":"132","author":"Une","year":"2015","journal-title":"Circulation"},{"key":"2019092004513058400_jez049-B29","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1161\/CIRCIMAGING.112.973834","article-title":"Global strain in severe aortic valve stenosis: relation to clinical outcome after aortic valve replacement","volume":"5","author":"Dahl","year":"2012","journal-title":"Circ Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B30","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1161\/CIRCIMAGING.114.002041","article-title":"Incremental prognostic value of left ventricular global longitudinal strain in patients with aortic stenosis and preserved ejection fraction","volume":"7","author":"Kusunose","year":"2014","journal-title":"Circ Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B31","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1161\/CIRCIMAGING.113.001177","article-title":"Decision making in asymptomatic aortic regurgitation in the era of guidelines: incremental values of resting and exercise cardiac dysfunction","volume":"7","author":"Kusunose","year":"2014","journal-title":"Circ Cardiovasc Imaging"},{"key":"2019092004513058400_jez049-B32","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1016\/j.echo.2011.08.003","article-title":"Detection of left ventricular dysfunction by global longitudinal systolic strain in patients with chronic aortic regurgitation","volume":"24","author":"Smedsrud","year":"2011","journal-title":"J Am Soc Echocardiogr"},{"key":"2019092004513058400_jez049-B33","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1111\/echo.13295","article-title":"Left ventricular reverse remodeling after aortic valve surgery for acute versus chronic aortic regurgitation","volume":"33","author":"Regeer","year":"2016","journal-title":"Echocardiography"},{"key":"2019092004513058400_jez049-B34","doi-asserted-by":"crossref","first-page":"29.","DOI":"10.1186\/1476-7120-8-29","article-title":"Reduced global longitudinal strain in association to increased left ventricular mass in patients with aortic valve stenosis and normal ejection fraction: a hybrid study combining echocardiography and magnetic resonance imaging","volume":"8","author":"Dinh","year":"2010","journal-title":"Cardiovasc Ultrasound"},{"key":"2019092004513058400_jez049-B35","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/j.amjcard.2010.11.032","article-title":"Relation of myocardial mechanics in severe aortic stenosis to left ventricular ejection fraction and response to aortic valve replacement","volume":"107","author":"Carasso","year":"2011","journal-title":"Am J Cardiol"}],"container-title":["European Heart Journal - Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/advance-article-pdf\/doi\/10.1093\/ehjci\/jez049\/28864427\/jez049.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcimaging\/article-pdf\/20\/10\/1105\/30034801\/jez049.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T08:51:50Z","timestamp":1568969510000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcimaging\/article\/20\/10\/1105\/5424124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,1]]},"references-count":35,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,4,1]]},"published-print":{"date-parts":[[2019,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjci\/jez049","relation":{},"ISSN":["2047-2404","2047-2412"],"issn-type":[{"value":"2047-2404","type":"print"},{"value":"2047-2412","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,10]]},"published":{"date-parts":[[2019,4,1]]}}}