{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:30:41Z","timestamp":1787729441218,"version":"build-2784847793"},"reference-count":28,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2009,1,15]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives:<\/jats:title>\n                  <jats:p>To identify functional aortic regurgitation (FAR) determinants in patients with ascending thoracic aortic aneurysm (ATAA) and surgically confirmed normal aortic valve anatomy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Case\u2013control study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>Non-invasive Cardiology and Cardiac Surgery Department.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients:<\/jats:title>\n                  <jats:p>Eighty-nine patients with ATAA and varying degrees of FAR undergoing surgery, 40 age-matched patients with ATAA without aortic regurgitation and 20 normal control subjects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions:<\/jats:title>\n                  <jats:p>Doppler and two-dimensional transoesophageal echocardiography.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures:<\/jats:title>\n                  <jats:p>Vena contracta (VC) of aortic regurgitant jet, diastolic tented area and coaptation height (CH) of aortic valve leaflets, aortic dimension indexes\u2014Valsalva sinus, sinotubular junction (STJ), tubular tract, annulus (A), STJ\/A ratio.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>When VC was used, a wide range of FAR was seen (mean (SD) 5.59 (2.59) mm, ranging from 2 to 13 mm). Of the variables tested, the most strongly associated with FAR severity in multivariate analysis was diastolic leaflet tenting, measured as CH (<jats:italic>R<\/jats:italic>\n                     <jats:sup>2<\/jats:sup>\u200a=\u200a0.69) (sensitivity 98%, specificity 95% using a cut-off value of CH \u2a7e1.1 cm). In turn, the diastolic leaflet tenting was strongly identified by the STJ\/A ratio (sensitivity 87%, specificity 71% using a cut-off value of STJ\/A &gt;1.66).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>The diastolic tenting of aortic leaflets is strongly related to FAR severity in patients with ATAA. The mismatch of STJ\/A is significantly associated with diastolic leaflet tenting and its correlated valve regurgitation, independently of the actual ATAA dimension. These findings provide new insight into the mechanism of FAR arising from ATAA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.2007.134494","type":"journal-article","created":{"date-parts":[[2008,2,28]],"date-time":"2008-02-28T20:55:24Z","timestamp":1204232124000},"page":"130-136","source":"Crossref","is-referenced-by-count":48,"title":["Determinants of the degree of functional aortic regurgitation in patients with anatomically normal aortic valve and ascending thoracic aorta aneurysm. Transoesophageal Doppler echocardiography study"],"prefix":"10.1136","volume":"95","author":[{"given":"G","family":"La Canna","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Maisano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"De Michele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Grimaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Grassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Capritti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"De Bonis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Alfieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2008,2,28]]},"reference":[{"key":"2025101710285281000_95.2.130.1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(95)00045-3"},{"key":"2025101710285281000_95.2.130.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)03236-2"},{"key":"2025101710285281000_95.2.130.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00698-0"},{"key":"2025101710285281000_95.2.130.4","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.118278"},{"key":"2025101710285281000_95.2.130.5","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/S0025-6196(12)65618-3","article-title":"Surgical pathology of pure aortic insufficiency: a study of 225 cases.","volume":"59","author":"Olson","year":"1984","journal-title":"Mayo Clin Proc"},{"key":"2025101710285281000_95.2.130.6","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(93)90267-K"},{"key":"2025101710285281000_95.2.130.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.01.096"},{"key":"2025101710285281000_95.2.130.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(03)00335-3"},{"key":"2025101710285281000_95.2.130.9","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.5.558"},{"key":"2025101710285281000_95.2.130.10","doi-asserted-by":"publisher","DOI":"10.1136\/heart.83.4.376"},{"key":"2025101710285281000_95.2.130.11","doi-asserted-by":"publisher","DOI":"10.1136\/heart.84.6.670"},{"key":"2025101710285281000_95.2.130.12","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)00893-C"},{"key":"2025101710285281000_95.2.130.13","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(85)90393-5"},{"key":"2025101710285281000_95.2.130.14","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S0022-5223(94)70465-1","article-title":"Aortic root and valve relationship: impact on surgical repair.","volume":"107","author":"Kunzelman","year":"1994","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025101710285281000_95.2.130.15","first-page":"111","article-title":"Permanent patency of the mouth of the aorta.","volume":"37","author":"Corrigan","year":"1832","journal-title":"Edinb Med Surg"},{"issue":"(SuppI)","key":"2025101710285281000_95.2.130.16","first-page":"I-36","article-title":"Aortic valve insufficiency due to aortic dilatation: correction by sinus rim adjustment.","volume":"74","author":"Frater","year":"1986","journal-title":"Circulation"},{"key":"2025101710285281000_95.2.130.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(97)80004-X"},{"key":"2025101710285281000_95.2.130.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2005.09.012"},{"key":"2025101710285281000_95.2.130.19","doi-asserted-by":"publisher","DOI":"10.1097\/01.hco.0000153951.31887.a6"},{"key":"2025101710285281000_95.2.130.20","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/S0022-5223(19)39144-5","article-title":"Cardiac valve surgery: \u201cthe French correction\u201d.","volume":"86","author":"Carpentier","year":"1983","journal-title":"Thorac Cardiovasc Surg"},{"issue":"(suppl II)","key":"2025101710285281000_95.2.130.21","first-page":"II-54","article-title":"Deformation dynamics of the aortic root. 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