{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:15:55Z","timestamp":1790230555989,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Pulmonary hypertension is an established outcome predictor in patients with aortic stenosis (AS), but the prognostic impact of right ventricular dysfunction has not been well studied.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              We included 2181 patients (50.4% men; mean age, 77 years) with aortic valve area &lt;1.3 cm\n              <jats:sup>2<\/jats:sup>\n              and analyzed the occurrence of all-cause death during follow-up according to tricuspid annular plane systolic excursion (TAPSE) quartiles.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Patients in the lowest quartile (TAPSE &lt;17 mm) were at a high risk of death, whereas survival was comparable for the 3 other quartiles. Five-year survival was 55\u00b12% for TAPSE &lt;17 mm, 72\u00b12% for TAPSE of 17 to 20 mm, 71\u00b12% for TAPSE of 20 to 24 mm, and 73\u00b12% for TAPSE &gt;24 mm (overall\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). TAPSE &lt;17 mm was associated with increased mortality after adjustment for established prognostic factors (adjusted hazard ratio [HR], 1.55 [95% CI, 1.21\u20131.97]) and after further adjustment for aortic valve replacement (AVR; adjusted HR, 1.47 [95% CI, 1.15\u20131.87]). The excess mortality risk associated with TAPSE &lt;17 mm was noticed in both patients managed initially conservatively (adjusted HR, 1.46 [95% CI, 1.20\u20131.76]) and patients who underwent early (within 3 months after diagnosis) AVR (adjusted HR, 1.61 [95% CI, 1.03\u20132.52]). In asymptomatic patients with severe AS and preserved ejection fraction, TAPSE &lt;17 mm was independently predictive of mortality (adjusted HR, 2.14 [95% CI, 1.31\u20133.51]). Early AVR was associated with similar survival benefit in TAPSE &lt;17 and \u226517 mm (adjusted HR, 0.23 [95% CI, 0.16\u20130.34] for TAPSE &lt;17 mm, adjusted HR, 0.26 [95% CI, 0.19\u20130.35] for TAPSE \u226517 mm;\n              <jats:italic>P<\/jats:italic>\n              for interaction, 0.97).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Right ventricular dysfunction is an important and independent predictor of mortality in AS. TAPSE &lt;17 mm at the time of AS diagnosis is a marker of poor survival under conservative management and after AVR even in asymptomatic patients with severe AS. AVR was associated with a pronounced reduction in mortality independent of TAPSE suggesting that AVR should be discussed before right ventricular dysfunction occurs in severe AS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.119.009802","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T10:00:32Z","timestamp":1579600832000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Impact of Right Ventricular Systolic Dysfunction on Outcome in Aortic Stenosis"],"prefix":"10.1161","volume":"13","author":[{"given":"Yohann","family":"Bohbot","sequence":"first","affiliation":[{"name":"Department of Cardiology, Amiens University Hospital, France (Y.B., P.G., D.R., M.K., C.T.)."},{"name":"EA 7517 MP3CV, Jules Verne University of Picardie, Amiens, France (Y.B., D.R., M.K., S.M., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Guignant","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amiens University Hospital, France (Y.B., P.G., D.R., M.K., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Rusinaru","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amiens University Hospital, France (Y.B., P.G., D.R., M.K., C.T.)."},{"name":"EA 7517 MP3CV, Jules Verne University of Picardie, Amiens, France (Y.B., D.R., M.K., S.M., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Kubala","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amiens University Hospital, France (Y.B., P.G., D.R., M.K., C.T.)."},{"name":"EA 7517 MP3CV, Jules Verne University of Picardie, Amiens, France (Y.B., D.R., M.K., S.M., C.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvestre","family":"Mar\u00e9chaux","sequence":"additional","affiliation":[{"name":"EA 7517 MP3CV, Jules Verne University of Picardie, Amiens, France (Y.B., D.R., M.K., S.M., C.T.)."},{"name":"Groupement des H\u00f4pitaux de l\u2019Institut Catholique de Lille, Facult\u00e9 libre de m\u00e9decine, Universit\u00e9 Lille Nord de France (S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Tribouilloy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amiens University Hospital, France (Y.B., P.G., D.R., M.K., C.T.)."},{"name":"EA 7517 MP3CV, Jules Verne University of Picardie, Amiens, France (Y.B., D.R., M.K., S.M., 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