{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:00:14Z","timestamp":1747184414904,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The implications of left ventricular remodeling and dysfunction before and after aortic valve replacement (AVR) for mixed aortic valve disease (MAVD) are not well understood. This study aims to evaluate the impact of AVR on left ventricular (LV) systolic function in MAVD, and determine the prognostic value of postoperative LV global longitudinal strain (LV\u2010GLS) and LV ejection fraction (LVEF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively assessed 489 consecutive patients with MAVD (defined as at least moderate aortic stenosis and at least moderate aortic regurgitation) and baseline LVEF \u226550%, who underwent AVR between February 2003 and August 2018. All patients had baseline echocardiography, whereas 192 patients underwent postoperative echocardiography between 3 and 18 months after AVR. The primary endpoint was all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 65\u00a0\u00b1\u00a015 years, and 65% were male. AVR in MAVD patients has a neutral effect on LV systolic function quantitated by LVEF and LV\u2010GLS. During a median follow\u2010up period of 5.8 years, 65 patients (34%) of 192 patients with follow\u2010up echocardiography died. The patients with postoperative LVEF \u226550% had better survival than those with postoperative LVEF\u00a0&lt;50% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Furthermore, among patients with postoperative LVEF \u226550%, mortality differed between patients with postoperative LV\u2010GLS worse than \u201315% and those with postoperative LV\u2010GLS better than \u201015% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with MAVD who underwent AVR, the mean postoperative LV\u2010GLS and LVEF remain at a similar value to baseline. However, worse postoperative LV\u2010GLS and LVEF were both independently associated with higher mortality in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15544","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T04:01:27Z","timestamp":1677729687000},"page":"318-326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic impact of left ventricular systolic dysfunction in patients with mixed aortic valve disease undergoing aortic valve replacement"],"prefix":"10.1111","volume":"40","author":[{"given":"Yoshihito","family":"Saijo","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5570-9402","authenticated-orcid":false,"given":"Tom Kai Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Isaza","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julijana Z.","family":"Conic","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric E.","family":"Roselli","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milind Y.","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard A.","family":"Grimm","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars G.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir R.","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian P.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5692-2299","authenticated-orcid":false,"given":"Zoran B.","family":"Popovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart, Thoracic and Vascular Institute Cleveland Clinic  Cleveland Ohio 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