{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:23:19Z","timestamp":1791919399137,"version":"4.3.4"},"reference-count":40,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"accepted":{"date-parts":[[2000,9,12]]},"published-print":{"date-parts":[[2001,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To identify variables that could be applied at rest to diagnose subclinical ventricular dysfunction in asymptomatic patients with severe aortic regurgitation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>DESIGN<\/jats:title>\n                  <jats:p>Cross sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PATIENTS<\/jats:title>\n                  <jats:p>Left ventricular long axis contraction was studied using tissue Doppler and M mode echocardiography in 21 patients with no symptoms (New York Heart Association (NYHA) functional class \u2a7d\u20092a) but severe aortic regurgitation (jet area\/left ventricular outflow tract area &gt;\u200940%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>MAIN OUTCOME MEASURES<\/jats:title>\n                  <jats:p>Left ventricular ejection fraction (LVEF) at baseline and peak exercise (Weber protocol), cardiopulmonary function, and left ventricular long axis function at rest (peak systolic velocity and excursion of the mitral annulus).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In 11 patients, ejection fraction increased or did not change (from mean (SD) 55 (5)% to 58 (4)%, p\u2009&lt;\u20090.05) (group I); in 10 patients it decreased by &gt;\u20095% (from 54 (4)% to 42 (5)%, p\u2009&lt;\u20090.001) (group II). Exercise ejection fraction was &lt;\u200950% in all patients in group II. At rest, there were no differences between the groups in ejection fraction, left ventricular diameter indices, wall stress, and short axis contraction. However, patients in group II had reduced long axis contraction compared with group I: peak systolic velocity 8.6 (0.6)<jats:italic>v<\/jats:italic> 11.9 (2.2)\u2009cm\/s (p\u2009&lt;\u20090.001); excursion 11 (2) <jats:italic>v<\/jats:italic> 14 (2)\u2009mm (p\u2009&lt;\u20090.01). A resting velocity of &lt;\u20099.5\u2009cm\/s was the best indicator of poor exercise tolerance (sensitivity 90%, specificity 100%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Markers of reduced long axis contraction may provide simple and reliable indices of subclinical left ventricular dysfunction in asymptomatic patients with severe aortic regurgitation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heart.85.1.30","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:37:59Z","timestamp":1027751879000},"page":"30-36","source":"Crossref","is-referenced-by-count":113,"title":["Assessment of left ventricular long axis contraction can detect early myocardial dysfunction in asymptomatic patients with severe aortic regurgitation"],"prefix":"10.1136","volume":"85","author":[{"given":"D","family":"Vinereanu","sequence":"first","affiliation":[{"name":"Cardiovascular Sciences Research Group, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A A","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Cardiovascular Sciences Research Group, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A G","family":"Fraser","sequence":"additional","affiliation":[{"name":"Cardiovascular Sciences Research Group, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,1,1]]},"reference":[{"key":"2025092100143706000_85.1.30.1","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1161\/01.CIR.61.3.484","article-title":"Observations on the optimum time for operative intervention for aortic regurgitation. II. Serial echocardiographic evaluation of asymptomatic patients.","volume":"61","author":"Henry","year":"1980","journal-title":"Circulation"},{"key":"2025092100143706000_85.1.30.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.4.1625"},{"key":"2025092100143706000_85.1.30.3","doi-asserted-by":"crossref","first-page":"587","DOI":"10.7326\/0003-4819-110-8-587","article-title":"Chronic aortic insufficiency: factors associated with progression to aortic valve replacement.","volume":"110","author":"Siemienczuk","year":"1989","journal-title":"Ann Intern Med"},{"key":"2025092100143706000_85.1.30.4","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1161\/01.CIR.97.6.525","article-title":"Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance.","volume":"97","author":"Borer","year":"1998","journal-title":"Circulation"},{"key":"2025092100143706000_85.1.30.5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.70.4.570"},{"key":"2025092100143706000_85.1.30.6","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S0735-1097(85)80422-8","article-title":"Ejection fraction response to supine exercise in asymptomatic aortic regurgitation: relation to simultaneous hemodynamic measurements.","volume":"5","author":"Massie","year":"1985","journal-title":"J Am Coll Cardiol"},{"key":"2025092100143706000_85.1.30.7","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1161\/01.CIR.71.1.31","article-title":"Evaluation of relationship between myocardial contractile state and left ventricular function in patients with aortic regurgitation.","volume":"71","author":"Shen","year":"1985","journal-title":"Circulation"},{"key":"2025092100143706000_85.1.30.8","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90560-N"},{"key":"2025092100143706000_85.1.30.9","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90453-R"},{"key":"2025092100143706000_85.1.30.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(89)80014-8"},{"key":"2025092100143706000_85.1.30.11","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1172\/JCI108079","article-title":"Wall stress and patterns of hypertrophy in the human left ventricle.","volume":"56","author":"Grossman","year":"1975","journal-title":"J Clin Invest"},{"key":"2025092100143706000_85.1.30.12","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(93)90068-K"},{"key":"2025092100143706000_85.1.30.13","first-page":"II9","article-title":"Detection of left ventricular hypertrophy by M-mode echocardiography. Anatomic validation, standardization, and comparison to other methods.","volume":"9 (suppl II)","author":"Devereux","year":"1987","journal-title":"Hypertension"},{"key":"2025092100143706000_85.1.30.14","first-page":"VI40","article-title":"Determination of aerobic capacity and the severity of chronic cardiac and circulatory failure.","volume":"76 (suppl VI)","author":"Weber","year":"1987","journal-title":"Circulation"},{"key":"2025092100143706000_85.1.30.15","first-page":"VI29","article-title":"Determinants and detection of anaerobic threshold and consequences of exercise above it.","volume":"76 (suppl VI)","author":"Wasserman","year":"1987","journal-title":"Circulation"},{"key":"2025092100143706000_85.1.30.16","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement.","volume":"i","author":"Bland","year":"1986","journal-title":"Lancet"},{"key":"2025092100143706000_85.1.30.17","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0022-5223(94)70004-4","article-title":"The St. Jude medical prosthesis: a 13 year experience.","volume":"108","author":"Ibrahim","year":"1994","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025092100143706000_85.1.30.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00205-2"},{"key":"2025092100143706000_85.1.30.19","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.10.2472"},{"key":"2025092100143706000_85.1.30.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(83)80278-2"},{"key":"2025092100143706000_85.1.30.21","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(90)90207-E"},{"key":"2025092100143706000_85.1.30.22","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.45.3.248"},{"key":"2025092100143706000_85.1.30.23","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.63.4.215"},{"key":"2025092100143706000_85.1.30.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(89)80026-4"},{"key":"2025092100143706000_85.1.30.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(14)80487-2"},{"key":"2025092100143706000_85.1.30.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)00033-1"},{"key":"2025092100143706000_85.1.30.27","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(96)90097-6"},{"key":"2025092100143706000_85.1.30.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(96)90251-3"},{"key":"2025092100143706000_85.1.30.29","first-page":"H226","article-title":"Left ventricular diastolic and systolic performance during chronic experimental aortic regurgitation.","volume":"263","author":"Magid","year":"1992","journal-title":"Am J Physiol"},{"key":"2025092100143706000_85.1.30.30","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1016\/0735-1097(89)90021-1","article-title":"Characteristic Doppler echocardiographic pattern of mitral inflow velocity in severe aortic regurgitation.","volume":"14","author":"Oh","year":"1989","journal-title":"J Am Coll Cardiol"},{"key":"2025092100143706000_85.1.30.31","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)88335-0"},{"key":"2025092100143706000_85.1.30.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)00002-3"},{"key":"2025092100143706000_85.1.30.33","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/BF00810523","article-title":"Impaired matching of perfusion and ventilation in heart failure detected by 133xenon.","volume":"91 (suppl 1)","author":"Lewis","year":"1996","journal-title":"Basic Res Cardiol"},{"key":"2025092100143706000_85.1.30.34","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(90)90208-F"},{"key":"2025092100143706000_85.1.30.35","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a014977"},{"key":"2025092100143706000_85.1.30.36","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(96)90019-X"},{"key":"2025092100143706000_85.1.30.37","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1159\/000176930","article-title":"Two-dimensional echocardiographic evaluation of left ventricular ejection fraction by the ellipsoid single-plane algorithm: a reliable method for assessing low or very low ejection fraction values?","volume":"86","author":"Corrao","year":"1995","journal-title":"Cardiology"},{"key":"2025092100143706000_85.1.30.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(14)80364-7"},{"key":"2025092100143706000_85.1.30.39","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(90)90010-3"},{"key":"2025092100143706000_85.1.30.40","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(99)70086-6"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heart.85.1.30","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T07:14:44Z","timestamp":1758438884000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heart.85.1.30"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,1,1]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2001,1,1]]},"published-print":{"date-parts":[[2001,1,1]]}},"alternative-id":["10.1136\/heart.85.1.30"],"URL":"https:\/\/doi.org\/10.1136\/heart.85.1.30","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,1,1]]}}}