{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T13:27:38Z","timestamp":1773408458916,"version":"3.50.1"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1_supplement","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2006,7,4]]},"abstract":"\n \n Background\u2014<\/jats:italic>\n <\/jats:bold>\n Concomitant functional mitral regurgitation (FMR) in patients undergoing aortic valve replacement (AVR) is frequently not corrected because it may improve after AVR; however, data supporting this assumption are sparse. We ascertained the impact of clinical and echocardiographic parameters on the outcome of patients with or without concomitant FMR at the time of AVR.\n <\/jats:p>\n \n \n Methods and Results\u2014<\/jats:italic>\n <\/jats:bold>\n Clinical and echocardiographic follow-up was performed on 848 patients who underwent AVR after 1990. Risk factors for mortality and a composite outcome of heart failure (CHF) symptoms, CHF death, or subsequent mitral repair or replacement, were examined with bootstrapped Cox proportional hazard models. Follow-up was 4591 patient-years (mean 5.4\u00b13.4 years; maximum 14.2 years). FMR \u22652+ had no independent adverse effect on survival in patients with aortic stenosis (AS) or insufficiency (AI). However, AS patients with FMR \u22652+ and 1 additional risk factor (left atrial diameter >5 cm, preoperative peak aortic valve gradient <60 mm Hg, or atrial fibrillation) were at increased risk for the composite outcome (hazard ratio [HR]: 2.7;\n P<\/jats:italic>\n =0.004). AI patients with FMR \u22652+ and a left ventricular end-systolic diameter <45 mm were also at risk (HR: 4.0;\n P<\/jats:italic>\n =0.02). Clinical risk factors in the AS and AI subgroups were associated with an increased likelihood of mitral regurgitation \u22652+ at 18 months postoperatively.\n <\/jats:p>\n \n \n Conclusions\u2014<\/jats:italic>\n <\/jats:bold>\n AS patients with FMR \u22652+ and a left atrial diameter >5 cm, preoperative peak aortic valve gradient <60 mm Hg, or atrial fibrillation have a significantly higher risk of CHF and persistent mitral regurgitation after AVR than other AS patients. AI patients with FMR \u22652+ and a left ventricular end-systolic diameter <45 mm preoperatively are also at increased risk. Others fare well after AVR.\n <\/jats:p>","DOI":"10.1161\/circulationaha.105.000976","type":"journal-article","created":{"date-parts":[[2006,7,7]],"date-time":"2006-07-07T01:56:58Z","timestamp":1152237418000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Natural History and Predictors of Outcome in Patients With Concomitant Functional Mitral Regurgitation at the Time of Aortic Valve Replacement"],"prefix":"10.1161","volume":"114","author":[{"given":"Marc","family":"Ruel","sequence":"first","affiliation":[{"name":"From Division of Cardiac Surgery (M.R., V.K., J.P., A.K., T.G.M.), the Department of Epidemiology (M.R.), and the Division of Cardiology (I.G.B.), University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varun","family":"Kapila","sequence":"additional","affiliation":[{"name":"From Division of Cardiac Surgery (M.R., V.K., J.P., A.K., T.G.M.), the Department of Epidemiology (M.R.), and the Division of Cardiology (I.G.B.), University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Price","sequence":"additional","affiliation":[{"name":"From Division of Cardiac Surgery (M.R., V.K., J.P., A.K., T.G.M.), the Department of Epidemiology (M.R.), and the Division of Cardiology (I.G.B.), University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Kulik","sequence":"additional","affiliation":[{"name":"From Division of Cardiac Surgery (M.R., V.K., J.P., A.K., T.G.M.), the Department of Epidemiology (M.R.), and the Division of Cardiology (I.G.B.), University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian G.","family":"Burwash","sequence":"additional","affiliation":[{"name":"From Division of Cardiac Surgery (M.R., V.K., J.P., A.K., T.G.M.), the Department of Epidemiology (M.R.), and the Division of Cardiology (I.G.B.), University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry G.","family":"Mesana","sequence":"additional","affiliation":[{"name":"From Division of Cardiac Surgery (M.R., V.K., J.P., A.K., T.G.M.), the Department of Epidemiology (M.R.), and the Division of Cardiology (I.G.B.), University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90865-A"},{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0886-0440.2004.00362.x"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960260306"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(03)00251-3"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.526046"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00506-7"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(96)70055-7"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.12.058"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(03)00335-3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.104.2.e8"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/euje.4.1.59"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00607-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.77.6.2967128"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2003.07.043"},{"key":"e_1_3_3_15_2","first-page":"630","volume":"112","year":"2005","unstructured":"Kulik A, Burwash IG, Kapila V, Walter O, Mesana TG, Ruel M. Long-term outcomes after valve replacement for low-gradient aortic stenosis: impact of patient-prosthesis mismatch. Circulation. 2005; 112 suppl II: 630(abstract).","journal-title":"Circulation"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)90977-9"},{"key":"e_1_3_3_17_2","first-page":"350","volume":"27","year":"2000","unstructured":"Christenson JT, Jordan B, Bloch A, Schmuziger M. Should a regurgitant mitral valve be replaced simultaneously with a stenotic aortic valve? Tex Heart Inst J. 2000; 27: 350\u2013355.","journal-title":"Tex Heart Inst J"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.105.000976","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T05:02:13Z","timestamp":1715576533000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.105.000976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,7,4]]},"references-count":17,"journal-issue":{"issue":"1_supplement","published-print":{"date-parts":[[2006,7,4]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.105.000976"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.105.000976","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,7,4]]},"assertion":[{"value":"2006-07-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}