{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:02Z","timestamp":1787018102254,"version":"build-2736575974"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,3,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Preoperative pulmonary hypertension (PH) is associated with excess mortality among patients with severe mitral regurgitation undergoing mitral valve surgery (MVS). However, the links between PH phenotype, pulmonary vascular remodeling, and persistent postoperative PH are not well understood. We aimed to describe the associations between components of pulmonary hemodynamics as well as postoperative residual PH with longitudinal mortality in patients with severe mitral regurgitation who received MVS.<\/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\">Patients undergoing MVS for severe mitral regurgitation from 2011 to 2016 were retrospectively identified within our health system (n=488). Mean pulmonary artery pressure and other hemodynamic variables were determined by presurgical right\u2010heart catheterization. Postoperative pulmonary artery systolic pressure was assessed on echocardiogram 42 to 365\u00a0days post\u2010MVS. Longitudinal survival over a mean 3.9\u00a0years of follow\u2010up was evaluated using Cox proportional hazards modeling to compare survival after adjustment for demographics, surgical characteristics, and comorbidities. Pre\u2010MVS prevalence of PH was high at 85%. After adjustment, each 10\u2010mm\u00a0Hg increase in preoperative mean pulmonary artery pressure was associated with a 1.38\u2010fold increase in risk of death (95% CI, 1.13\u20131.68). Elevated preoperative pulmonary vascular resistance, transpulmonary gradient, and right atrial pressure were similarly associated with increased mortality. Among 231 patients with postoperative echocardiogram, evidence of PH on echocardiogram (pulmonary artery systolic pressure \u226535\u00a0mm\u00a0Hg) was associated with increased risk of death (hazard ratio [HR], 2.02 [95% CI, 1.17\u20133.47]); however, this was no longer statistically significant after adjustment (HR, 1.55 [95% CI, 0.85\u20132.85]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients undergoing MVS for mitral regurgitation, preoperative PH, and postoperative PH were associated with increased mortality.<\/jats:p>\n                  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