{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T08:00:18Z","timestamp":1774598418078,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Physio Funct Imaging"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Assessing subclinical myocardial dysfunction in aortic regurgitation (AR) with preserved left ventricular ejection fraction (LVEF) is challenging due to load\u2010dependent conventional parameters. Non\u2010invasive myocardial work (MW) integrates left ventricular pressure and strain to provide afterload\u2010adjusted performance indices. This study aimed to characterize MW across AR severity in patients with preserved LVEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We prospectively enroled 130 patients categorized as control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930), mild (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930), moderate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934), and severe (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936) according to guidelines. MW parameters were assessed using Vivid E95 ultrasound and included: global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Compared to controls, AR groups demonstrated reduced GWI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with severe AR group significantly lower than mild\/moderate groups. GCW (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) decreased in moderate\/severe AR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). GWW progressively increased (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and GWE decreased (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) from mild to severe AR. ROC analysis revealed excellent discrimination between severe AR and controls: GWI (AUC: 0.892), GCW (AUC: 0.806), GWW (AUC: 0.961), and GWE (AUC: 0.982). Intra\u2010 and inter\u2010observer variability was excellent (ICCs\u2009&gt;\u20090.80).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010invasive MW indices, particularly GWW and GWE, progressively deteriorate with AR severity in preserved LVEF patients. These findings provide novel, physiology\u2010based insights into myocardial energetic efficiency in chronic volume overload. MW parameters may offer incremental value in functional evaluation, potentially aiding subclinical dysfunction identification. Future large\u2010scale, longitudinal studies are warranted to validate prognostic utility and role in optimizing intervention timing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cpf.70057","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:27:23Z","timestamp":1773397643000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying myocardial function characteristic with myocardial work measurement in patients with different aortic regurgitation severity"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1002-7271","authenticated-orcid":false,"given":"Ziwei","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing Medical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital China Pharmaceutical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing University of Chinese Medicine Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xixi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing Medical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital China Pharmaceutical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing University of Chinese Medicine Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junyi","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing Medical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital China Pharmaceutical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing University of Chinese Medicine Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linlin","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing Medical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital China Pharmaceutical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing University of Chinese Medicine Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaowu","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing Medical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital China Pharmaceutical University Nanjing China"},{"name":"Department of Echocardiography, Nanjing First Hospital Nanjing University of Chinese Medicine Nanjing 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