{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:41:45Z","timestamp":1788176505141,"version":"build-2803163510"},"reference-count":23,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T00:00:00Z","timestamp":1694390400000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,8,18]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Drug therapy to reduce the regurgitation fraction (RF) of high-grade aortic regurgitation (AR) by increasing heart rate (HR) is generally recommended. However, chronic HR reduction in HFREF patients can significantly improve aortic compliance and thereby potentially decrease RF. To clarify these contrasts, we examined the influence of HR, aortic compliance and stroke volume (SV) on RF in an ex vivo porcine model of severe AR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Experiments were performed on porcine ascending aorta with aortic valves (n=12). Compliance was varied by inserting a Dacron graft close to the aortic valve. Both tube systems were connected to a left heart simulator varying HR and SV. AR was accomplished by punching a 0.3 cm\n                      <jats:sup>2<\/jats:sup>\n                      hole in one aortic cusp. Flow, RF, SV and aortic pressure were measured, aortic compliance with transoesophageal ultrasound probes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compliance of the aorta was significantly reduced after Dacron graft insertion (0.55%\u00b10.21%\/mm Hg vs 0.01%\u00b10.007%\/mm Hg, p&lt;0.001, respectively). With increasing HR, RF was significantly reduced in each steady state of the native aorta (HR 40 bpm: 88%\u00b17% vs HR 120 bpm: 42%\u00b110%; p&lt;0.001), but Dacron tube did not affect RF (HR 40 bpm: 87%\u00b18%; p=0.79; HR 120 bpm: 42%\u00b13%; p=0.86). Increasing SV also reduced RF independent of the stiff Dacron graft.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Aortic compliance did not affect AR in the ex vivo porcine model of AR. RF was significantly reduced with increasing HR and SV. These results affirm that HR lowering and negative inotropic drugs should be avoided to treat severe AR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002319","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T13:35:12Z","timestamp":1694439312000},"page":"e002319","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of heart rate, aortic compliance and stroke volume on the aortic regurgitation fraction studied in an ex vivo pig model"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1053-5175","authenticated-orcid":false,"given":"Jan Christian","family":"Reil","sequence":"first","affiliation":[{"name":"Cardiology, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Saisho","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Universit\u00e4tsklinikum Schleswig-Holstein Universit\u00e4res Herzzentrum L\u00fcbeck, Lubeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Jockwer","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Universit\u00e4tsklinikum Schleswig-Holstein Universit\u00e4res Herzzentrum L\u00fcbeck, Lubeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buntaro","family":"Fujita","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Universit\u00e4tsklinikum Schleswig-Holstein Universit\u00e4res Herzzentrum L\u00fcbeck, Lubeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lech","family":"Paluszkiewicz","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert-Hinrich","family":"Reil","sequence":"additional","affiliation":[{"name":"Cardiology, Klinikum Oldenburg AoR, Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Ensminger","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Universit\u00e4tsklinikum Schleswig-Holstein Universit\u00e4res Herzzentrum L\u00fcbeck, Lubeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Scharfschwerdt","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Universit\u00e4tsklinikum Schleswig-Holstein Universit\u00e4res Herzzentrum L\u00fcbeck, Lubeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Aboud","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Universit\u00e4tsklinikum Schleswig-Holstein Universit\u00e4res Herzzentrum L\u00fcbeck, Lubeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,9,11]]},"reference":[{"key":"2025081612000960000_10.2.e002319.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395"},{"key":"2025081612000960000_10.2.e002319.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.02.016"},{"key":"2025081612000960000_10.2.e002319.3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1093\/icvts\/ivaa232","article-title":"Reduced left ventricular contractility, increased diastolic operant stiffness and high energetic expenditure in patients with severe aortic regurgitation without indication for surgery","volume":"32","author":"Reil","year":"2021","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2025081612000960000_10.2.e002319.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050666"},{"key":"2025081612000960000_10.2.e002319.5","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1161\/01.CIR.44.3.355","article-title":"Quantitative hemodynamic effects of heart rate in aortic regurgitation","volume":"44","author":"Judge","year":"1971","journal-title":"Circulation"},{"key":"2025081612000960000_10.2.e002319.6","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1161\/01.RES.9.2.413","article-title":"Effect of heart rate on aortic insufficiency as measured by a dye-dilution technique","volume":"9","author":"Warner","year":"1961","journal-title":"Circ Res"},{"key":"2025081612000960000_10.2.e002319.7","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(82)90203-X"},{"key":"2025081612000960000_10.2.e002319.8","first-page":"502","article-title":"Impact of heart rate on flow measurements in aortic regurgitation","volume":"26","author":"Lid\u00e9n","year":"2017","journal-title":"J Heart Valve Dis"},{"key":"2025081612000960000_10.2.e002319.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.027"},{"key":"2025081612000960000_10.2.e002319.10","doi-asserted-by":"publisher","DOI":"10.1097\/01.MAT.0000137038.03251.35"},{"key":"2025081612000960000_10.2.e002319.11","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2021-001775","article-title":"Aortic distensibility in Marfan syndrome: a potential predictor of aortic events","volume":"8","author":"van Andel","year":"2021","journal-title":"Open Heart"},{"key":"2025081612000960000_10.2.e002319.12","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs218"},{"key":"2025081612000960000_10.2.e002319.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.12.059"},{"key":"2025081612000960000_10.2.e002319.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-010-0207-x"},{"key":"2025081612000960000_10.2.e002319.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2009.09.002"},{"key":"2025081612000960000_10.2.e002319.16","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90832-T"},{"key":"2025081612000960000_10.2.e002319.17","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.108.806240"},{"key":"2025081612000960000_10.2.e002319.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61198-1"},{"key":"2025081612000960000_10.2.e002319.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.028"},{"key":"2025081612000960000_10.2.e002319.20","first-page":"H773","article-title":"Left ventricular interaction with arterial load studied in isolated canine ventricle","volume":"245","author":"Sunagawa","year":"1983","journal-title":"Am J Physiol"},{"key":"2025081612000960000_10.2.e002319.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.10.047"},{"key":"2025081612000960000_10.2.e002319.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.03.610"},{"key":"2025081612000960000_10.2.e002319.23","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00404.2004"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2023-002319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T19:00:17Z","timestamp":1755370817000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2023-002319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":23,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,9,11]]},"published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1136\/openhrt-2023-002319"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2023-002319","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}