{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:55:23Z","timestamp":1785549323513,"version":"3.56.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T00:00:00Z","timestamp":1613174400000},"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":[[2021,5,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The goal of this study was to investigate the long-term outcome of aortic valve replacement (AVR) for severe aortic insufficiency with a focus on pre- and postoperative left ventricular (LV) function to explore predictive factors that influence the recovery of LV function and clinical outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A total of 478 patients who underwent AVR for pure severe aortic insufficiency were grouped according to the preoperative echocardiographical LV ejection fraction (EF): low (LO) EF &amp;lt;35% (n\u2009=\u200943), moderate EF 35\u201350% (n\u2009=\u2009150) or normal EF &amp;gt;50% (n\u2009=\u2009285).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Actuarial survival at 10\u2009years post-AVR was 64% with a LO EF, 92% with a moderate EF and 93% with a normal EF (P\u2009=\u20090.016), whereas 10-year rates of freedom from major adverse cerebral and cardiovascular events were 47%, 79% and 84%, respectively (P\u2009&amp;lt;\u20090.0001). Echocardiography at 1\u2009year post-AVR demonstrated that EF substantially improved in all groups. We noted a significant difference in survival (P\u2009=\u20090.0086) and in freedom from major adverse cerebral and cardiovascular events (P\u2009=\u20090.024) between patients with an EF \u226535% and those with an EF &amp;lt;35% in the LO EF group. The multivariable logistic regression model showed that predictive factors for lack of improvement in EF 1\u2009year post-AVR in the LO EF group included plasma brain natriuretic peptide &amp;gt;365\u2009pg\/mL (P\u2009=\u20090.0022) and echocardiographic LV mass index) &amp;gt;193\u2009g\/m2 (P\u2009=\u20090.0018).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Long-term outcome post-AVR for severe aortic insufficiency was largely influenced by preoperative LV function. Predictive factors of failure to recover ventricular function post-AVR included EF &amp;lt;25%, pre-brain natriuretic peptide &amp;gt;365\u2009pg\/mL or LV mass index &amp;gt;193\u2009g\/m2.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivab020","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T12:38:42Z","timestamp":1610973522000},"page":"846-854","source":"Crossref","is-referenced-by-count":7,"title":["Reverse left ventricular remodelling after aortic valve replacement for severe aortic insufficiency"],"prefix":"10.1093","volume":"32","author":[{"given":"Teppei","family":"Toya","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan"},{"name":"Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9481-8860","authenticated-orcid":false,"given":"Satsuki","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2829-5325","authenticated-orcid":false,"given":"Yusuke","family":"Shimahara","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Kasahara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjiro","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,13]]},"reference":[{"key":"2022031517054483700_ivab020-B1","doi-asserted-by":"crossref","first-page":"S134","DOI":"10.1161\/CIRCULATIONAHA.108.839787","article-title":"Survival in patients with severe aortic regurgitation and severe left ventricular dysfunction is improved by aortic valve replacement: results from a cohort of 166 patients with an ejection fraction &lt; or =35%","volume":"120","author":"Kamath","year":"2009","journal-title":"Circulation"},{"key":"2022031517054483700_ivab020-B2","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1161\/01.CIR.99.14.1851","article-title":"Mortality and morbidity of aortic regurgitation in clinical practice. 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