{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:30:44Z","timestamp":1784709044470,"version":"3.55.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Patients with only moderate atrial secondary mitral regurgitation (asMR) frequently develop heart failure (HF). Mechanisms of HF with moderate asMR and the impact of mild asMR remain unclarified. Although mild\/moderate primary mitral regurgitation is compensated by left ventricular (LV) dilatation, the LV is not dilated in asMR. We hypothesized that patients with mild asMR without LV dilatation may have impaired hemodynamics and higher risks of subsequent symptomatic HF deterioration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Stroke volume, cardiac output, and systolic pulmonary artery pressure were measured by echocardiography in 142 patients with isolated atrial fibrillation and 30 healthy controls. The prognosis of patients with isolated atrial fibrillation was followed up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              In the 142 patients with isolated atrial fibrillation, asMR was no\/trivial in 55, mild in 83, moderate in 4, while none had severe asMR. Compared with controls and patients with no\/trivial asMR, LV end-diastolic volume index was not increased and hemodynamic parameters were abnormal in patients with mild asMR (LV end-diastolic volume index, 65\u00b16 versus 58\u00b18 versus 60\u00b18 mL\/m\u00b2; stroke volume index, 42\u00b14 versus 35\u00b14 versus 29\u00b16 mL\/m\u00b2;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001 versus other 2 groups; cardiac output index, 2.8\u00b10.4 versus 2.8\u00b10.5 versus 2.3\u00b10.6 L\/min per m\u00b2;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001; systolic pulmonary artery pressure, 21\u00b13 versus 26\u00b15 versus 37\u00b19 mm\u2005Hg;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001). Although the event-free rate of HF symptomatic deterioration or hospitalization in patients with no\/trivial asMR during a median 13.9 months follow-up was 86.9% and 100%, the rate in mild asMR was 59.4% and 85.0% (\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001 or\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.032), respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>In the presence of isolated AF and no compensatory LV dilatation, impaired hemodynamics and higher risks of symptomatic HF deterioration were associated with mild asMR, requiring further studies of causalities.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.123.016239","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T10:00:31Z","timestamp":1709114431000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Potential Effects of Mild Atrial Secondary Mitral Regurgitation in Patients With Isolated Atrial Fibrillation"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7860-2747","authenticated-orcid":true,"given":"Jun","family":"Akashi","sequence":"first","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Iwataki","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4329-2819","authenticated-orcid":true,"given":"Yosuke","family":"Nabeshima","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-1214","authenticated-orcid":true,"given":"Takeshi","family":"Onoue","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Shiga University of Medical Science, Japan (A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Tanaga","sequence":"additional","affiliation":[{"name":"Departments of Clinical Laboratory (T.T.), Miyazaki Medical Association Hospital Cardiovascular Center, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5879-4382","authenticated-orcid":true,"given":"Shun","family":"Nishino","sequence":"additional","affiliation":[{"name":"Cardiology (S.N., T.K., Y.S.), Miyazaki Medical Association Hospital Cardiovascular Center, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Kimura","sequence":"additional","affiliation":[{"name":"Cardiology (S.N., T.K., Y.S.), Miyazaki Medical Association Hospital Cardiovascular Center, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Yano","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery (M.Y.), Miyazaki Medical Association Hospital Cardiovascular Center, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-411X","authenticated-orcid":true,"given":"Nozomi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Cardiovascular Physiology, Faculty of Medicine, University of Miyazaki, Japan (N.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4879-8245","authenticated-orcid":true,"given":"Yuki","family":"Tsuda","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3927-3906","authenticated-orcid":true,"given":"Masaru","family":"Araki","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshisato","family":"Shibata","sequence":"additional","affiliation":[{"name":"Cardiology (S.N., T.K., Y.S.), Miyazaki Medical Association Hospital Cardiovascular Center, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan (Y. Nishimura)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2388-0103","authenticated-orcid":true,"given":"Yutaka","family":"Otsuji","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8034-1005","authenticated-orcid":true,"given":"Masaharu","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine (J.A., M.I., Y. Nabeshima, T.O., Y.T., M.A., Y.O., M.K.)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.06.032"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.11.009"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2022.08.016"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz314"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-17-1334"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000932"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2021.03.003"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041451"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.755942"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2115"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.01.049"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.1699"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.05.010"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.102.12.1400"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.11.013"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)37479-3"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0894-7317(97)80009-0"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90356-t"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.112.000328"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.109.865683"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.09.013"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-20-0971"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.51.2.273"}],"container-title":["Circulation: Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCIMAGING.123.016239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T21:10:38Z","timestamp":1748553038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCIMAGING.123.016239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1161\/CIRCIMAGING.123.016239"],"URL":"https:\/\/doi.org\/10.1161\/circimaging.123.016239","relation":{},"ISSN":["1941-9651","1942-0080"],"issn-type":[{"value":"1941-9651","type":"print"},{"value":"1942-0080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3]]},"assertion":[{"value":"2023-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}