{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T19:37:38Z","timestamp":1770233858165,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T00:00:00Z","timestamp":1566172800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Secondary mitral regurgitation (MR) is common in patients with left bundle branch block (LBBB) undergoing cardiac resynchronization therapy (CRT). We aimed to define CRT effects on left ventricular (LV) and mitral valve (MV) geometry, and their correlation with MR severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010one patients with LBBB and \u2265mild secondary MR underwent CRT between 2009 and 2012, and had baseline and follow\u2010up echocardiograms available. Repeated measure and linear regression analyses were performed to assess for changes in MV and LV geometry and MR severity, and associations with follow\u2010up MR grade.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age and baseline QRS duration were 65.5\u00a0\u00b1\u00a014.9\u00a0years and 160\u00a0\u00b1\u00a024\u00a0ms. At a mean follow\u2010up of 2.6\u00a0\u00b1\u00a01.8\u00a0years, there was an increase in LV ejection fraction and reductions in LV end\u2010systolic volume index, MR grade, and end\u2010systolic interpapillary muscle distance (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05 for all). Linear correlations were observed between follow\u2010up MR grade and baseline MV tenting height (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.44), left atrial volume index (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.41), LV end\u2010systolic volume index (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.4), MV tenting area (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.38), LV ejection fraction (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u2212.34), and end\u2010systolic interpapillary muscle distance (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.34) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05 for all). Multiple regression analysis revealed associations between follow\u2010up MR grade and baseline MV tenting height (<jats:italic>\u03b2<\/jats:italic>\/mm\u00a0=\u00a00.42, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.006) and left atrial volume index (<jats:italic>\u03b2<\/jats:italic>\/mL\/m<jats:sup>2<\/jats:sup>\u00a0=\u00a00.4, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.008), independent of QRS duration (<jats:italic>\u03b2<\/jats:italic>\/ms=\u22120.07; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.6) and nonischemic cardiomyopathy (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22120.34, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cardiac resynchronization therapy in patients with LBBB and secondary MR results in LV and MV geometric reverse remodeling and decreases MR severity. Extent of baseline MV tethering is independently associated with persistent MR at follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14444","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T11:55:04Z","timestamp":1566215704000},"page":"1450-1458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The effects of cardiac resynchronization therapy on left ventricular and mitral valve geometry and secondary mitral regurgitation in patients with left bundle branch block"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6338-4791","authenticated-orcid":false,"given":"Christos G.","family":"Mihos","sequence":"first","affiliation":[{"name":"Echocardiography Laboratory, Division of Cardiology, Mount Sinai Heart Institute Columbia University Miami Beach Florida"},{"name":"Cardiac Ultrasound Laboratory Harvard Medical School Massachusetts General 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A.","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary P.","family":"Orencole","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Service, Harvard Medical School Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jagmeet P.","family":"Singh","sequence":"additional","affiliation":[{"name":"Cardiac Arrhythmia Service, Harvard Medical School Massachusetts General Hospital Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael H.","family":"Picard","sequence":"additional","affiliation":[{"name":"Cardiac Ultrasound Laboratory Harvard Medical School Massachusetts General Hospital Boston 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