{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T09:35:39Z","timestamp":1768988139118,"version":"3.49.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,12,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The objectives of the present study were (1) to evaluate the echocardiographic prognostic factors associated with improved left ventricular (LV) systolic function after aortic valve replacement, and (2) to compare the long\u2010term outcomes after aortic valve replacement in chronic aortic regurgitation (AR) patients with or without LV dysfunction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 280 patients who underwent aortic valve replacement because of chronic aortic regurgitation were studied. Patients with reduced LV systolic function (LV ejection fraction [LVEF] &lt;50%; group reduced LVEF [rEF]; N=80) were compared with those with preserved LV systolic function (LVEF \u226550%; group preserved LVEF; N=200). Postoperative clinical outcomes, overall survival, and freedom from cardiac death were compared. Postoperative echocardiographic examinations were reviewed, and changes in echocardiographic parameters were analyzed. The parameters related to LVEF improvement or normalization were evaluated, and risk factors affecting long\u2010term survival were identified. Follow\u2010up was complete in 100% of patients, with a median follow\u2010up of 104.8\u00a0months. Overall and cardiac mortality\u2010free survival rates at postoperative 10\u00a0years were 80.1% and 92.9% and 87.3% and 97.2% in groups rEF and preserved LVEF, respectively (\n              <jats:italic>P<\/jats:italic>\n              =0.036 and\n              <jats:italic>P<\/jats:italic>\n              =0.058, respectively). LVEF tended to decrease in the early postoperative period but improved thereafter in both groups. Preoperative early diastolic transmitral flow velocity\/mitral annular tissue velocity ratio was a parameter of postoperative improvement or normalization of LVEF in all patients (area under the curve, 0.719;\n              <jats:italic>P<\/jats:italic>\n              =0.003) and in group rEF patients (area under the curve, 0.726;\n              <jats:italic>P<\/jats:italic>\n              =0.011) with a cutoff value of 12.73. Preoperative early diastolic transmitral flow velocity\/mitral annular tissue velocity ratio also was the parameter of overall survival in all patients (hazard ratio [HR], 1.08;\n              <jats:italic>P<\/jats:italic>\n              =0.001) and in group rEF patients (HR, 1.08;\n              <jats:italic>P<\/jats:italic>\n              =0.005).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Long\u2010term outcomes and survival after aortic valve replacement were related to preoperative LV function in patients with chronic aortic regurgitation. Preoperative early diastolic transmitral flow velocity\/mitral annular tissue velocity ratio was correlated with the postoperative improvement or normalization of LVEF and long\u2010term survival, especially in group rEF patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018292","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T11:52:36Z","timestamp":1607428356000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Prognostic Markers and Long\u2010Term Outcomes After Aortic Valve Replacement in Patients With Chronic Aortic Regurgitation"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3425-882X","authenticated-orcid":false,"given":"Min\u2010Seok","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Surgery Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun\u2010Chel","family":"Joo","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sak","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1498-4111","authenticated-orcid":false,"given":"Young\u2010Nam","family":"Youn","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0311-6565","authenticated-orcid":false,"given":"Seung Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery Severance Cardiovascular HospitalYonsei University College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000031"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.1862"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00584-7"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/stcs.2002.32368"},{"key":"e_1_3_1_6_2","first-page":"II100","article-title":"Valve replacement in chronic aortic regurgitation: true predictors of survival after extended follow\u2010up","volume":"98","author":"Turina J","year":"1998","unstructured":"Turina J, Milincic J, Seifert B, Turina M. Valve replacement in chronic aortic regurgitation: true predictors of survival after extended follow\u2010up. Circulation. 1998;98:II100\u2013II106.","journal-title":"Circulation"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.12.068"},{"key":"e_1_3_1_8_2","first-page":"372","article-title":"Outcomes of surgery for severe aortic regurgitation with systolic left ventricular dysfunction","volume":"26","author":"Bruno P","year":"2017","unstructured":"Bruno P, Cammertoni F, Rosenhek R, Mazza A, Nesta M, Burzotta F, D'Amario D, Massetti M. Outcomes of surgery for severe aortic regurgitation with systolic left ventricular dysfunction. J Heart Valve Dis. 2017;26:372\u2013379.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.4.1625"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(82)90032-7"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)37982-6"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.538272"},{"key":"e_1_3_1_13_2","first-page":"VI17","article-title":"Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure","volume":"87","author":"Cintron G","year":"1993","unstructured":"Cintron G, Johnson G, Francis G, Cobb F, Cohn JN; The V\u2010HeFT VA Cooperative Studies Group . Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure. Circulation. 1993;87:VI17\u2013VI23.","journal-title":"Circulation"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.1025"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.01.026"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.08.045"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.024"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivv365"},{"key":"e_1_3_1_19_2","first-page":"III133","article-title":"Natural history of left ventricular performance at rest and during exercise after aortic valve replacement for aortic regurgitation","volume":"84","author":"Borer JS","year":"1991","unstructured":"Borer JS, Herrold EM, Hoschreiter C, Roman M, Supino P, Devereux RB, Kligfield P, Nawaz H. Natural history of left ventricular performance at rest and during exercise after aortic valve replacement for aortic regurgitation. Circulation. 1991;84:III133\u2013III139.","journal-title":"Circulation"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1159\/000490848"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.12.025"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-16-0782"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jex148"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20437"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.01.011"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.4250\/jcu.2011.19.4.169"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.12.037"},{"key":"e_1_3_1_28_2","first-page":"OC09","article-title":"Associations between left ventricle diastolic dysfunction and unfavorable prognostic markers in patients with aortic insufficiency","volume":"11","author":"Roscani MG","year":"2017","unstructured":"Roscani MG, Duarte JDC, Augusto GN, Salgueiro TRM, Meireles MN, Gobbi JIF, Okoshi K, Hueb JC. Associations between left ventricle diastolic dysfunction and unfavorable prognostic markers in patients with aortic insufficiency. J Clin Diagn Res. 2017;11:OC09\u2013OC11.","journal-title":"J Clin Diagn Res"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.018292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:03:36Z","timestamp":1715598216000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.018292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,15]]},"references-count":27,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2020,12,15]]}},"alternative-id":["10.1161\/JAHA.120.018292"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.018292","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,15]]},"assertion":[{"value":"2020-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e018292"}}