{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T05:50:02Z","timestamp":1771653002912,"version":"3.50.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Myocardial contraction fraction (MCF) is a volumetric measure of myocardial shortening independent of left ventricular size and geometry. This multicenter study investigates the usefulness of MCF for risk stratification in low-gradient severe aortic stenosis with preserved ejection fraction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We included 643 consecutive patients with low-gradient severe aortic stenosis with preserved ejection fraction in whom MCF was computed at baseline and analyzed mortality during follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Throughout follow-up with medical and surgical management (34.9 [16.1\u201365.3] months), lower MCF tertiles had higher mortality than the highest tertile. Eighty-month survival was 56\u00b14% for MCF&gt;41%, 41\u00b14% for MCF 30% to 41%, and 40\u00b14% for MCF&lt;30% (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). After comprehensive adjustment, mortality risk remained high for MCF 30% to 41% (adjusted hazard ratio, 1.53 [1.08\u20132.18]) and for MCF&lt;30% (adjusted hazard ratio, 1.82 [1.24\u20132.66]) versus MCF&gt;41%. The optimal MCF cutoff point for mortality prediction was 41%. Age, body mass index, Charlson index, peak aortic velocity, and ejection fraction were independently associated with mortality. MCF (\u03c7\n              <jats:sup>2<\/jats:sup>\n              to improve 10.39;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.001), provided greater additional prognostic value over the baseline parameters than stroke volume (SV) index (\u03c7\n              <jats:sup>2<\/jats:sup>\n              to improve 5.41;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.042), left ventricular mass index (\u03c7\n              <jats:sup>2<\/jats:sup>\n              to improve 2.15;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.137), or global longitudinal strain (\u03c7\n              <jats:sup>2<\/jats:sup>\n              to improve 3.67;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.061). MCF outperformed ejection fraction for mortality prediction. When patients were classified by SV index and MCF, mortality risk was low when SV index was \u226530 mL\/m\n              <jats:sup>2<\/jats:sup>\n              and MCF&gt;41%, higher for patients with SV index \u226530 mL\/m\n              <jats:sup>2<\/jats:sup>\n              and MCF\u226441% (adjusted hazard ratio, 1.47 [1.05\u20132.07]) and extremely high for patients with SV index &lt;30 mL\/m\n              <jats:sup>2<\/jats:sup>\n              (adjusted hazard ratio, 2.29 [1.45\u20133.62]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>MCF is a valuable marker of risk in low-gradient severe aortic stenosis with preserved ejection fraction and could improve decision-making, especially in normal-flow low-gradient severe aortic stenosis with preserved ejection fraction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.120.012257","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T14:08:05Z","timestamp":1629209285000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Myocardial Contraction Fraction for Risk Stratification in Low-Gradient Aortic Stenosis With Preserved Ejection Fraction"],"prefix":"10.1161","volume":"14","author":[{"given":"Dan","family":"Rusinaru","sequence":"first","affiliation":[{"name":"P\u00f4le Coeur-Thorax-Vaisseaux, Department of Cardiology (D.R., Y.B., M.K., C.T.), University Hospital Amiens, France."},{"name":"Centre Universitaire de Recherche en Sant\u00e9, Laboratoire MP3CV - 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