{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:00:04Z","timestamp":1793642404110,"version":"4.5.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,2,15]],"date-time":"2022-02-15T00:00:00Z","timestamp":1644883200000},"content-version":"vor","delay-in-days":0,"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":[[2022,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Long-term left ventricular assist device (LVAD) support can cause accelerated progression of aortic insufficiency (AI). The MOMENTUM trial has led to increased use of the HeartMate 3 (HM3) LVAD, due to greater hemocompatibility. However, the differential effect on the rate of progression of AI during HM3 support versus HeartMate 2 (HM2) has not been extensively studied. This analysis compares the rates of progression to moderate or severe AI (MSAI) comparing a cohort of patients supported with the HM2 versus HM3.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A retrospective review was performed on all consecutive patients implanted with HM2 or HM3 between May 2005 and June 2020. Follow-up time was limited to the first 6 years after LVAD implantation. Demographics and 4005 echocardiograms were assessed for 536 HM2 and 300 HM3 patients. The primary end point was progression to MSAI. Univariable and multivariable Cox proportional hazard regression and landmark analyses were performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Progression to MSAI was greater in the HM2 (17%) versus HM3 (9.9%) cohort. On the univariable analysis, the hazard ratio for HM3 was 0.581 (95% confidence interval 0.370\u20130.909, P\u2009=\u20090.02) whereas on multivariable analysis hazard ratio was 0.624 (95% confidence interval 0.386\u20131.008, P\u2009=\u20090.0537). Preoperative AI, female sex and body surface area &amp;lt;2 were significantly associated with progression to MSAI. Landmark analysis suggests that LVAD type has the most significant effect on progression to MSAI between 1 and 2\u2009years post-implantation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Current practice strategies achieved low rates of progression to MSAI. Preoperative AI, female sex and body surface area &amp;lt;2 were the most important predictors of progression to MSAI. Pump type appears to be of secondary importance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac087","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T04:12:39Z","timestamp":1643343159000},"page":"1188-1196","source":"Crossref","is-referenced-by-count":16,"title":["Progression of aortic valve insufficiency during centrifugal versus axial flow left ventricular assist device support"],"prefix":"10.1093","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1269-9587","authenticated-orcid":false,"given":"Fabian","family":"Jimenez Contreras","sequence":"first","affiliation":[{"name":"Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9348-7708","authenticated-orcid":false,"given":"Michelle","family":"Mendiola Pla","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Schroder","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Bryner","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richa","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1115-0349","authenticated-orcid":false,"given":"Stuart D","family":"Russell","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Mirza","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mani A","family":"Daneshmand","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Milano","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,15]]},"reference":[{"key":"2022050515422395600_ezac087-B1","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.athoracsur.2020.12.038","article-title":"The Society of Thoracic Surgeons Intermacs 2020 Annual Report","volume":"111","author":"Molina","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2022050515422395600_ezac087-B2","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1161\/CIRCHEARTFAILURE.109.917765","article-title":"The development of aortic insufficiency in left ventricular assist device-supported patients","volume":"3","author":"Cowger","year":"2010","journal-title":"Circ Heart Fail"},{"key":"2022050515422395600_ezac087-B3","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/j.jchf.2018.07.012","article-title":"Aortic insufficiency during contemporary left ventricular assist device support: analysis of the INTERMACS Registry","volume":"6","author":"Truby","year":"2018","journal-title":"JACC Heart Fail"},{"key":"2022050515422395600_ezac087-B4","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/j.jtcvs.2012.11.066","article-title":"Natural history and clinical effect of aortic valve regurgitation after left ventricular assist device implantation","volume":"145","author":"Rajagopal","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022050515422395600_ezac087-B5","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1016\/j.jacc.2014.01.053","article-title":"Results of the destination therapy post-food and drug administration approval study with a continuous flow left ventricular assist device: a prospective study using the INTERMACS registry (interagency registry for mechanically assisted circulatory support)","volume":"63","author":"Jorde","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2022050515422395600_ezac087-B6","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jtcvs.2015.09.060","article-title":"Selective management strategy of interrupted aortic arch mitigates left ventricular outflow tract obstruction risk","volume":"151","author":"Alsoufi","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022050515422395600_ezac087-B7","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.healun.2005.11.451","article-title":"Is native aortic valve commissural fusion in patients with long-term left ventricular assist devices associated with clinically important aortic insufficiency?","volume":"25","author":"Letsou","year":"2006","journal-title":"J Heart Lung Transplant"},{"key":"2022050515422395600_ezac087-B8","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/j.healun.2010.05.018","article-title":"Prevalence of de novo aortic insufficiency during long-term support with left ventricular assist devices","volume":"29","author":"Pak","year":"2010","journal-title":"J Heart Lung Transplant"},{"key":"2022050515422395600_ezac087-B9","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.cardfail.2017.04.012","article-title":"The hemodynamic effects of aortic insufficiency in patients supported with continuous-flow left ventricular assist devices","volume":"23","author":"Sayer","year":"2017","journal-title":"J Card Fail"},{"key":"2022050515422395600_ezac087-B10","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.athoracsur.2019.12.030","article-title":"Aortic insufficiency after left ventricular assist device implantation: predictors and outcomes","volume":"110","author":"Kagawa","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2022050515422395600_ezac087-B11","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.healun.2016.07.018","article-title":"Aortic insufficiency in continuous-flow left ventricular assist device support patients is common but does not impact long-term mortality","volume":"36","author":"Holley","year":"2017","journal-title":"J Heart Lung Transplant"},{"key":"2022050515422395600_ezac087-B12","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1056\/NEJMoa1900486","article-title":"A fully magnetically levitated left ventricular assist device\u2014final report","volume":"380","author":"Mehra","year":"2019","journal-title":"N Engl J Med"},{"key":"2022050515422395600_ezac087-B13","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1056\/NEJMoa1800866","article-title":"two-year outcomes with a magnetically levitated cardiac pump in heart failure","volume":"378","author":"Mehra","year":"2018","journal-title":"N Engl J Med"},{"key":"2022050515422395600_ezac087-B14","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1056\/NEJMoa1610426","article-title":"A fully magnetically levitated circulatory pump for advanced heart failure","volume":"376","author":"Mehra","year":"2017","journal-title":"N Engl J Med"},{"key":"2022050515422395600_ezac087-B15"},{"key":"2022050515422395600_ezac087-B16","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/j.echo.2018.04.002","article-title":"Evaluation of the integrative algorithm for grading chronic aortic and mitral regurgitation severity using the current American Society of Echocardiography Recommendations: to discriminate severe from moderate regurgitation","volume":"31","author":"Gao","year":"2018","journal-title":"J Am Soc Echocardiogr"},{"key":"2022050515422395600_ezac087-B17","author":"Uriel","year":"2021"},{"key":"2022050515422395600_ezac087-B18","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.athoracsur.2012.09.020","article-title":"The development of aortic insufficiency in continuous-flow left ventricular assist device-supported patients","volume":"95","author":"Aggarwal","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2022050515422395600_ezac087-B19","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/j.athoracsur.2014.05.030","article-title":"De novo aortic regurgitation after continuous-flow left ventricular assist device implantation","volume":"98","author":"Patil","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2022050515422395600_ezac087-B20","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1093\/ejcts\/ezv204","article-title":"Influence of aortic valve opening in patients with aortic insufficiency after left ventricular assist device implantation","volume":"49","author":"da Rocha","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022050515422395600_ezac087-B21","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1097\/MAT.0000000000001071","article-title":"Moderate aortic insufficiency with a left ventricular assist device portends a worse long-term survival","volume":"66","author":"Auvil","year":"2020","journal-title":"ASAIO J"},{"key":"2022050515422395600_ezac087-B22","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/aor.13825","article-title":"Impact of worsening of aortic insufficiency during HeartMate 3 LVAD support","volume":"45","author":"Imamura","year":"2021","journal-title":"Artif Organs"},{"key":"2022050515422395600_ezac087-B23","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0735-1097(00)00744-0","article-title":"Prevalence and correlates of aortic regurgitation in American Indians: the Strong Heart Study","volume":"36","author":"Lebowitz","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"2022050515422395600_ezac087-B24","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/MED.0000000000000471","article-title":"Risk factors for valvular calcification","volume":"26","author":"Chen","year":"2019","journal-title":"Curr Opin Endocrinol Diabetes Obes"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/61\/5\/1188\/43517979\/ezac087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/61\/5\/1188\/43517979\/ezac087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T15:44:33Z","timestamp":1651765473000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/61\/5\/1188\/6528951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,15]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,2,15]]},"published-print":{"date-parts":[[2022,5,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac087","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,5,1]]},"published":{"date-parts":[[2022,2,15]]}}}