{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:14:13Z","timestamp":1791670453909,"version":"4.3.4"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T00:00:00Z","timestamp":1657843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006020","name":"Center for Translational Molecular Medicine","doi-asserted-by":"publisher","award":["grant 01C-203"],"award-info":[{"award-number":["grant 01C-203"]}],"id":[{"id":"10.13039\/501100006020","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002996","name":"Hartstichting","doi-asserted-by":"publisher","award":["2015T082"],"award-info":[{"award-number":["2015T082"]}],"id":[{"id":"10.13039\/501100002996","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["016.176.340"],"award-info":[{"award-number":["016.176.340"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Aims<\/jats:title>\n<jats:p>Progressive changes to left atrial (LA) structure and function following mitral regurgitation (MR) remain incompletely understood. This study aimed to demonstrate potential underlying mechanisms using experimental canine models and computer simulations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A canine model of MR was created by cauterization of mitral chordae followed by radiofrequency ablation-induced left bundle-branch block (LBBB) after 4 weeks (MR-LBBB group). Animals with LBBB alone served as control. Echocardiography was performed at baseline, acutely after MR induction, and at 4 and 20 weeks, and correlated with histology and computer simulations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Acute MR augmented LA reservoir and contractile strain (40\u00b14 to 53\u00b16% and -11\u00b15 to -22\u00b19% respectively, p&lt;0.05). LA fractional area change increased significantly (47\u00b14 to 56\u00b14%, p&lt;0.05) while LA end-systolic area remained unchanged (7.2\u00b11.1 versus 7.9\u00b11.1 cm<jats:sup>2<\/jats:sup> respectively, p = 0.08). LA strain \u2018pseudonormalized\u2019 after 4 weeks and decompensated at 20 weeks with both strains decreasing to 25\u00b16% and -3\u00b12% respectively (p&lt;0.05) together with a progressive increase in LA end-systolic area (7.2\u00b11.1 to 14.0\u00b16.3 cm<jats:sup>2<\/jats:sup>, p&lt;0.05). In the LBBB-group, LA remodeling was less pronounced. Histology showed a trend towards increased interstitial fibrosis in the LA of the MR-LBBB group. Computer simulations indicated that the progressive changes in LA structure and function are a combination of progressive eccentric remodeling and fibrosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>MR augmented LA strain acutely to supranormal values without significant LA dilation. However, over time, LA strain gradually decreases (pseudornormal and decompensated) with LA dilation. Histology and computer simulations indicated a correlation to a varying degree of LA eccentric remodeling and fibrosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0271588","type":"journal-article","created":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T17:27:00Z","timestamp":1657906020000},"page":"e0271588","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Left atrial remodeling in mitral regurgitation: A combined experimental-computational study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8358-2231","authenticated-orcid":true,"given":"Sjoerd","family":"Bouwmeester","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"van 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