{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:26:25Z","timestamp":1774977985487,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Most guidelines directing clinicians to manage valve disease are directed at single valve lesions. Limited data exists to direct our understanding of how concomitant valve disease impacts the left ventricle (LV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 2817 patients with aortic stenosis (AS) from the echocardiography laboratory database between September 2012 and June 2018 who had a LV ejection fraction (EF) \u226550%. LV mass, LV mass index, LV systolic pressure (systolic blood pressure + peak aortic gradient). Covariates were collected from the electronic medical record. Multi\u2010variate analysis of covariance was used to generate adjusted comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our population was 66% female, 17% African\u2010American with a mean age of 65 years. Of note, 7.3% were noted to have significant (moderate\/severe) aortic regurgitation (AR), and 11% had significant (moderate\/severe) mitral regurgitation (MR). Adjusting for covariates at different levels, significant MR had a much stronger association with heart failure compared to those with significant AR (<jats:italic>p<\/jats:italic> &lt; .001 vs. <jats:italic>p<\/jats:italic> = .313, respectively) at all levels of adjustment. Both significant mitral and AR exhibited an association with increasing left ventricular mass, even with adjustment for baseline demographics and clinical features (<jats:italic>p<\/jats:italic> &lt; .001 vs. <jats:italic>p<\/jats:italic> = .007, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with AS, 16% also experience at least moderate MR or AR. Further, significant MR has a stronger association with heart failure than significant AR, even though both increase left ventricular mass. Those with moderate AS and significant MR or AR experience similar or higher levels of heart failure compared to severe AS without regurgitation. Mixed valve disease merits further studies to direct longitudinal management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15503","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T05:05:20Z","timestamp":1671167120000},"page":"37-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence and clinical associations of mitral and aortic regurgitation in patients with aortic stenosis"],"prefix":"10.1111","volume":"40","author":[{"given":"Petro","family":"Gjini","sequence":"first","affiliation":[{"name":"Evans Department of Medicine Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodie F.","family":"Kenes","sequence":"additional","affiliation":[{"name":"Dearborn Cardiology  Dearborn Michigan 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Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Pu","sequence":"additional","affiliation":[{"name":"Division of Cardiology Albert Einstein School of Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bharathi","family":"Upadhya","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Department of Internal Medicine Wake Forest University School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard Brandon","family":"Stacey","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine Department of Internal Medicine Wake Forest University School of Medicine  Winston\u2010Salem North Carolina 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