{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:07:10Z","timestamp":1761419230247,"version":"3.40.4"},"reference-count":0,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2018]]},"abstract":"<b><i>Background:<\/i><\/b> Noninvasive measurement of myocardial contractility (end-systolic wall stress-adjusted change in left ventricular ejection fraction from rest to exercise [\u0394LVEF \u2013 \u0394ESS]) predicts heart failure, subnormal LVEF<sub>rest<\/sub>, and sudden death in asymptomatic patients with chronic severe aortic regurgitation (AR). Here we assess the relation of preoperative \u0394LVEF \u2013 \u0394ESS to survival after aortic valve replacement (AVR). <b><i>Methods:<\/i><\/b> Patients who underwent AVR for chronic, isolated, pure severe AR (<i>n<\/i> = 66) were followed for 13.0 \u00b1 6.4 event-free years. Preoperative \u0394LVEF \u2013 \u0394ESS (from combined echocardiographic and radionuclide cineangiographic data) enabled cohort stratification into 3 terciles (\u20131 to \u201311% [normal or mild] contractility deficit, \u201312 to \u201316% [moderate], and \u2264\u201317% [severe], identical with segregation in our earlier study) to relate preoperative contractility to postoperative survival and to age- and gender-matched US census data. <b><i>Results:<\/i><\/b><i><\/i> Since AVR, 22 patients died (average annual risk [AAR] for all-cause mortality for the entire co hort = 3.15%). Preoperative \u0394LVEF \u2013 \u0394ESS predicted postoperative survival (<i>p<\/i> = 0.009, log rank test). By contractility terciles, all-cause AARs were 1.44, 2.58, and 6.40%. Survival was lower than among US census comparators (<i>p<\/i> &#x3c; 0.02), but the \u201cmild\u201d tercile was indistinguishable from census data (<i>p<\/i> = ns). By multivariable Cox regression, survival prediction by pre-AVR \u0394LVEF \u2013 \u0394ESS was independent of, and superior to, prediction by age at surgery, gender, preoperative functional class, LVEF<sub>rest<\/sub>, LVEF<sub>exercise<\/sub>, change in LVEF<sub>rest to exercise<\/sub>, and LV diastolic or systolic dimensions (<i>p<\/i> \u2264 0.01, pre-AVR \u0394LVEF \u2013 \u0394ESS vs. other covariates). <b><i>Conclusion:<\/i><\/b> In severe AR, preoperative contractility predicts post-AVR survival and may be prognostically superior to clinical, geometric and performance descriptors, potentially impacting on patient selection for surgery.<\/jats:p>","DOI":"10.1159\/000490848","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T21:01:44Z","timestamp":1535058104000},"page":"204-212","source":"Crossref","is-referenced-by-count":5,"title":["Survival after Aortic Valve Replacement for Aortic Regurgitation: Prediction from Preoperative Contractility Measurement"],"prefix":"10.1159","volume":"140","author":[{"given":"Jeffrey\u00a0S.","family":"Borer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phyllis\u00a0G.","family":"Supino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmund\u00a0McM.","family":"Herrold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony","family":"Innasimuthu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Hochreiter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Krieger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard\u00a0N.","family":"Girardi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.\u00a0Wayne","family":"Isom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2018,8,23]]},"container-title":["Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/490848","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/490848","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:42:56Z","timestamp":1745426576000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000490848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,10,25]]},"published-print":{"date-parts":[[2018,11,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000490848","archive":["Portico"],"relation":{},"ISSN":["0008-6312","1421-9751"],"issn-type":[{"type":"print","value":"0008-6312"},{"type":"electronic","value":"1421-9751"}],"subject":[],"published":{"date-parts":[[2018]]}}}