{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:36:35Z","timestamp":1790620595186,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Functional mitral regurgitation (FMR) is associated with poor outcome in systolic heart failure (HF) patients. Percutaneous edge\u2010to\u2010edge mitral valve repair (PMVR) in Mitra\u2010Fr study failed to prove any beneficial effect over optimal medical treatment (OMT) but win in COAPT study. Nevertheless, little is known about the effect of PMVR on LV performance and mechanics in HF patients with severe secondary MR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method and results<\/jats:title><jats:p>Thirty\u2010seven patients with severe FMR undergoing PMVR were included and compared (according to indices of LV myocardial function and the relationship between LV\u2010size and the degree of regurgitation) to nineteen patients with FMR treated by OMT. Both groups were clinically comparable. At 6\u2010month follow\u2010up, cardiac index such as LV global constructive work (GCW) improved significantly in both groups (1.86 vs 2.13\u00a0L\/min\/m<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02, 1.73 vs 2.28\u00a0L\/min\/m<jats:sup>2<\/jats:sup> <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002 and 977 vs 1101\u00a0mm\u00a0Hg.%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003, 967 vs 1110\u00a0mm\u00a0Hg.%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002 for PMVR and OMT groups, respectively) whereas left ventricular (LV) end\u2010systolic volume index, LV ejection fraction, and global longitudinal strain were not different. Receiver operating characteristics in PMVR with LVEF\u00a0\u2264\u00a035% subgroup analysis demonstrated that global work index (GWI) had the best ability to identify patients with worse evolution (AUC\u00a0=\u00a00.882; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.009), confirmed by univariable logistic regression, particularly for patients with GWI\u00a0&lt;\u00a0482\u00a0mm\u00a0Hg.%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Echocardiographic characteristics at 6\u2010month follow\u2010up are not different when compare PMVR and OMT for HF patients with severe FMR. A low global work index might be a tool for discouraging the implantation of clips for this indication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14523","type":"journal-article","created":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T11:25:47Z","timestamp":1572866747000},"page":"2010-2018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Left ventricular function after correction of mitral regurgitation: Impact of the clipping approach"],"prefix":"10.1111","volume":"36","author":[{"given":"Arnaud","family":"Hubert","sequence":"first","affiliation":[{"name":"CHU Rennes Inserm LTSI \u2013 UMR 1099 University of Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9584-5505","authenticated-orcid":false,"given":"Elena","family":"Galli","sequence":"additional","affiliation":[{"name":"CHU Rennes Inserm LTSI \u2013 UMR 1099 University of Rennes Rennes 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