{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:35:24Z","timestamp":1787589324746,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>To prevent left ventricular dysfunction (LVD), surgery is recommended in patients with severe primary mitral regurgitation as soon as ejection fraction (EF) \u226460% or LV end-systolic diameter \u226540 mm. However, LVD may be concealed behind preoperative normal LVEF and LV end-systolic diameter. We sought to identify whether a new composite echocardiographic Doppler marker of the LV ejection according to the LV dilatation may predict postoperative LVD and outcome after mitral valve repair in patients with primary mitral regurgitation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Between 1991 and 2010, patients who underwent mitral valve repair for primary mitral regurgitation were studied. From preoperative echocardiography, we calculated LV ejection index (LVEI) using following formula: LVEI=indexed LV end-systolic diameter\/LV outflow tract time\u2013velocity integral. In the 278 patients included, the best correlation with postoperative LVEF was found with LVEI (\n              <jats:italic>r<\/jats:italic>\n              =\u22120.40;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), even in patients with preoperative LVEF\u226560% (\n              <jats:italic>r<\/jats:italic>\n              =\u22120.46;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). In multivariable analysis, LCEI&gt;1.13 was an independent predictor of postoperative LVD (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). During a mean follow-up of 10\u00b14.6 years, 67 (29%) deaths occurred. When compared with patients with preserved LVEI, those with LVEI&gt;1.13 had significantly lower both survival and cardiac death\u2013free survival (\n              <jats:italic>P<\/jats:italic>\n              =0.017 and\n              <jats:italic>P<\/jats:italic>\n              =0.008, respectively). Similar results were found in patients with preoperative LVEF\u226560% (\n              <jats:italic>P<\/jats:italic>\n              =0.049 and\n              <jats:italic>P<\/jats:italic>\n              =0.016, respectively). In Cox proportional hazard model, after meticulous adjustment for cofactors, LVEI&gt;1.13 remains independently associated with death (hazard ratio, 1.64;\n              <jats:italic>P<\/jats:italic>\n              =0.039) and cardiac-related death (hazard ratio, 3.27;\n              <jats:italic>P<\/jats:italic>\n              =0.026).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>After mitral valve repair for primary mitral regurgitation, the preoperative LVEI is a new and simple composite parameter of both LV dilatation and LV forward flow able to accurately predict postoperative LVD and outcome.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.114.003036","type":"journal-article","created":{"date-parts":[[2015,9,4]],"date-time":"2015-09-04T03:19:12Z","timestamp":1441336752000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical and Prognostic Impact of a New Left Ventricular Ejection Index in Primary Mitral Regurgitation Because of Mitral Valve Prolapse"],"prefix":"10.1161","volume":"8","author":[{"given":"Julien","family":"Magne","sequence":"first","affiliation":[{"name":"From the CHU Limoges, H\u00f4pital Dupuytren, Department of Cardiology, Limoges, France (J.M.); INSERM 1094, Facult\u00e9 de m\u00e9decine de Limoges, Limoges, France (J.M.); Department of cardiology, University Hospital Amiens, Amiens Cedex 1, France (C.S., A.F., D.M., C.T.); Department of Cardiology, Timone University Hospital, Marseille, France (J.F.A.); Inserm UMR S910, Aix Marseille University, Marseille, France (J.F.A.); and INSERM U-1088, University of Picardie, Amiens, France (C.S., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Szymanski","sequence":"additional","affiliation":[{"name":"From the CHU Limoges, H\u00f4pital Dupuytren, Department of Cardiology, Limoges, France (J.M.); INSERM 1094, Facult\u00e9 de m\u00e9decine de Limoges, Limoges, France (J.M.); Department of cardiology, University Hospital Amiens, Amiens Cedex 1, France (C.S., A.F., D.M., C.T.); Department of Cardiology, Timone University Hospital, Marseille, France (J.F.A.); Inserm UMR S910, Aix Marseille University, Marseille, France (J.F.A.); and INSERM U-1088, University of Picardie, Amiens, France (C.S., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Fournier","sequence":"additional","affiliation":[{"name":"From the CHU Limoges, H\u00f4pital Dupuytren, Department of Cardiology, Limoges, France (J.M.); INSERM 1094, Facult\u00e9 de m\u00e9decine de Limoges, Limoges, France (J.M.); Department of cardiology, University Hospital Amiens, Amiens Cedex 1, France (C.S., A.F., D.M., C.T.); Department of Cardiology, Timone University Hospital, Marseille, France (J.F.A.); Inserm UMR S910, Aix Marseille University, Marseille, France (J.F.A.); and INSERM U-1088, University of Picardie, Amiens, France (C.S., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doroth\u00e9e","family":"Malaquin","sequence":"additional","affiliation":[{"name":"From the CHU Limoges, H\u00f4pital Dupuytren, Department of Cardiology, Limoges, France (J.M.); INSERM 1094, Facult\u00e9 de m\u00e9decine de Limoges, Limoges, France (J.M.); Department of cardiology, University Hospital Amiens, Amiens Cedex 1, France (C.S., A.F., D.M., C.T.); Department of Cardiology, Timone University Hospital, Marseille, France (J.F.A.); Inserm UMR S910, Aix Marseille University, Marseille, France (J.F.A.); and INSERM U-1088, University of Picardie, Amiens, France (C.S., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Fran\u00e7ois","family":"Avierinos","sequence":"additional","affiliation":[{"name":"From the CHU Limoges, H\u00f4pital Dupuytren, Department of Cardiology, Limoges, France (J.M.); INSERM 1094, Facult\u00e9 de m\u00e9decine de Limoges, Limoges, France (J.M.); Department of cardiology, University Hospital Amiens, Amiens Cedex 1, France (C.S., A.F., D.M., C.T.); Department of Cardiology, Timone University Hospital, Marseille, France (J.F.A.); Inserm UMR S910, Aix Marseille University, Marseille, France (J.F.A.); and INSERM U-1088, University of Picardie, Amiens, France (C.S., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Tribouilloy","sequence":"additional","affiliation":[{"name":"From the CHU Limoges, H\u00f4pital Dupuytren, Department of Cardiology, Limoges, France (J.M.); INSERM 1094, Facult\u00e9 de m\u00e9decine de Limoges, Limoges, France (J.M.); Department of cardiology, University Hospital Amiens, Amiens Cedex 1, France (C.S., A.F., D.M., C.T.); Department of Cardiology, Timone University Hospital, Marseille, France (J.F.A.); Inserm UMR S910, Aix Marseille University, Marseille, France (J.F.A.); and INSERM U-1088, University of Picardie, Amiens, France (C.S., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000029"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.2.830"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90151-1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jer128"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.06.047"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.599175"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-301128"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.073239"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2012.04.009"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-12-0665"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(98)90059-6"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.57.2.244"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet105"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.001251"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht345"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.938241"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq399"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm072"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jes068"}],"container-title":["Circulation: Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCIMAGING.114.003036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:50:34Z","timestamp":1715568634000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCIMAGING.114.003036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1161\/CIRCIMAGING.114.003036"],"URL":"https:\/\/doi.org\/10.1161\/circimaging.114.003036","relation":{},"ISSN":["1941-9651","1942-0080"],"issn-type":[{"value":"1941-9651","type":"print"},{"value":"1942-0080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9]]},"assertion":[{"value":"2014-12-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-08-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-09-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e003036"}}