{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:51:57Z","timestamp":1773103917266,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T00:00:00Z","timestamp":1694822400000},"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":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aimed to investigate the mechanisms and clinical implications of mitral regurgitation (MR) in patients with severe aortic stenosis (AS) who received transcatheter aortic valve replacement (TAVR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted retrospective echocardiographic analyses at baseline and 6 months after TAVR in 140 patients with symptomatic AS (85\u00a0\u00b1\u00a05 years) who underwent TAVR. We defined significant MR as \u2265 moderate based on evaluation of transthoracic echocardiography (TTE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 48 patients (34%) with preexisting MR at the baseline. Among measured TTE parameters, end\u2010systolic wall stress (ESWS), mitral annulus area, and mitral valve thickening index were independent factors associated with preexisting MR (odds ratio [OR]: 1.013, 95% confidence interval [CI]: 1.005\u20131.021; OR: 1.740, 95% CI: 1.314\u20132.376; OR: 2.306, 95% CI: 1.426\u20133.848; respectively). Six months after TAVR, there were 34 patients with post\u2010existing MR, A history of atrial fibrillation and ESWS after TAVR were independent factors (OR: 3.013, 95% CI: 1.208\u20137.556; OR: 1.013, 95% CI: 1.000\u20131.023; respectively). The Kaplan\u2013Meier plot indicated that preexisting MR was a risk factor for heart failure\u2013related events within 1 year of discharge after TAVR (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients who underwent TAVR for severe AS, preexisting MR was associated with having a thickened mitral valve and large mitral annulus size induced by high ESWS. These patients may have worse prognosis after TAVR and should be closely monitored in the long term.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15693","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T09:24:41Z","timestamp":1694856281000},"page":"1187-1195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mechanisms and implications of mitral regurgitation in patients with severe aortic stenosis who received transcatheter aortic valve replacement"],"prefix":"10.1111","volume":"40","author":[{"given":"Hitomi","family":"Horinouchi","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Internal Medicine Tokai University School of Medicine  Isehara\u2010shi Kanagawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoo","family":"Nagai","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Internal 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