{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:34:55Z","timestamp":1787589295254,"version":"build-2736575974"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,11]]},"abstract":"\n Background<\/jats:title>\n \n The timing of mitral valve surgery in asymptomatic patients with primary mitral regurgitation (\n MR<\/jats:styled-content>\n ) is controversial. We hypothesized that the forward left ventricular (LV) ejection fraction (\n LVEF<\/jats:styled-content>\n ; ie,\n LV<\/jats:styled-content>\n outflow tract stroke volume divided by\n LV<\/jats:styled-content>\n end\u2010diastolic volume) is superior to the total\n LVEF<\/jats:styled-content>\n to predict outcomes in\n MR<\/jats:styled-content>\n . The objective of this study was to examine the association between echocardiographic parameters of\n MR<\/jats:styled-content>\n severity and\n LV<\/jats:styled-content>\n function and outcomes in patients with\n MR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n The clinical and Doppler\u2010echocardiographic data of 278 patients with \u2265mild\n MR<\/jats:styled-content>\n and no class I indication of mitral valve surgery at baseline were retrospectively analyzed. The primary study end point was the composite of mitral valve surgery or death. During a mean follow\u2010up of 5.4\u00b13.2\u00a0years, there were 147 (53%) events: 96 (35%)\n MV<\/jats:styled-content>\n surgeries and 66 (24%) deaths. Total\n LVEF<\/jats:styled-content>\n and global longitudinal strain were not associated with the occurrence of events, whereas forward\n LVEF<\/jats:styled-content>\n (\n P<\/jats:italic>\n <0.0001) and\n LV<\/jats:styled-content>\n end\u2010systolic diameter (\n P<\/jats:italic>\n =0.0003) were. After adjustment for age, sex,\n MR<\/jats:styled-content>\n severity, Charlson probability, coronary artery disease, and atrial fibrillation, forward\n LVEF<\/jats:styled-content>\n remained independently associated with the occurrence of events (adjusted hazard ratio: 1.09, [95% confidence interval]: 1.02\u20131.17 per 5% decrease;\n P<\/jats:italic>\n =0.01), whereas\n LV<\/jats:styled-content>\n end\u2010systolic diameter was not (\n P<\/jats:italic>\n =0.48).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The results of this study suggest that the forward\n LVEF<\/jats:styled-content>\n may be superior to the total\n LVEF<\/jats:styled-content>\n and\n LV<\/jats:styled-content>\n end\u2010systolic diameter to predict outcomes in patients with primary\n MR<\/jats:styled-content>\n . This simple and easily measurable parameter may be useful to improve risk stratification and select the best timing for intervention in patients with primary\n MR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006309","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T20:10:32Z","timestamp":1509135032000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Forward Left Ventricular Ejection Fraction: A Simple Risk Marker in Patients With Primary Mitral Regurgitation"],"prefix":"10.1161","volume":"6","author":[{"given":"Marl\u00e8ne","family":"Dupuis","sequence":"first","affiliation":[{"name":"Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec\/Qu\u00e9bec Heart & Lung Institute Laval University, Qu\u00e9bec City, Qu\u00e9bec, 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