{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:37:51Z","timestamp":1789925871288,"version":"4.0.1"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Atrioventricular regurgitation is frequent in the setting of heart failure. It is due to atrial and ventricular remodelling, as well as rhythmic disturbances and loss of synchrony. Once atrioventricular regurgitation develops, it can aggravate the underlying heart failure, and further participate and aggravate its own severity. Its presence is therefore concomitantly a surrogate of advance disease and a predictor of mortality. Heart failure management, including medical therapy, cardiac resynchronization therapy, and restoration of sinus rhythm, are the initial steps to reduce atrioventricular regurgitation. In the current review, we analyse the current data assessing the epidemiology, pathophysiology, and impact of non-valvular intervention on atrioventricular regurgitation including medical treatment, cardiac resynchronization and atrial fibrillation ablation.<\/jats:p>","DOI":"10.3389\/fcvm.2021.713658","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T04:36:55Z","timestamp":1635136615000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Epidemiology, Pathophysiology, and Management of Native Atrioventricular Valve Regurgitation in Heart Failure Patients"],"prefix":"10.3389","volume":"8","author":[{"given":"Anne-C\u00e9line","family":"Martin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-C\u00e9cile","family":"Bories","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemie","family":"Tence","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Baudinaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Pechmajou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Puscas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloi","family":"Marijon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Achouh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Karam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/S0140-6736(06)69208-8","article-title":"Burden of valvular heart diseases: a population-based study","volume":"368","author":"Nkomo","year":"2006","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.15420\/cfr.2016:25:2","article-title":"Global public health burden of heart failure","volume":"3","author":"Savarese","year":"2017","journal-title":"Card Fail Rev."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1002\/ejhf.813","article-title":"Epidemiology and one-year outcomes in patients with chronic heart failure and preserved, mid-range and reduced ejection fraction: an analysis of the ESC heart failure long-term registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur J Heart Fail."},{"key":"B4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/eurheartj\/ehx402","article-title":"Refining the prognostic impact of functional mitral regurgitation in chronic heart failure","volume":"39","author":"Goliasch","year":"2018","journal-title":"Eur Heart J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.1056\/NEJMoa1805374","article-title":"Percutaneous repair or medical treatment for secondary mitral regurgitation","volume":"379","author":"Obadia","year":"2018","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2307","DOI":"10.1056\/NEJMoa1806640","article-title":"Transcatheter mitral-valve repair in patients with heart failure","volume":"379","author":"Stone","year":"2018","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1161\/CIRCULATIONAHA.118.038946","article-title":"Excess mortality associated with functional tricuspid regurgitation complicating heart failure with reduced ejection fraction","volume":"140","author":"Benfari","year":"2019","journal-title":"Circulation."},{"key":"B8","doi-asserted-by":"publisher","first-page":"4051","DOI":"10.1002\/ehf2.13014","article-title":"The prevalence, predictors, and prognosis of tricuspid regurgitation in stage B and C heart failure with preserved ejection fraction","volume":"7","author":"Ren","year":"2020","journal-title":"ESC Heart Fail."},{"key":"B9","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1093\/ejechocard\/jen188","article-title":"Mitral regurgitation in dilated cardiomyopathy: value of both regional left ventricular contractility and dyssynchrony","volume":"10","author":"Donal","year":"2009","journal-title":"Eur J Echocardiogr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1093\/europace\/euaa217","article-title":"Atrial fibrillation ablation in heart failure: what do we know? What can we do?","volume":"23","author":"Chiocchini","year":"2021","journal-title":"Europace."},{"key":"B11","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.jcmg.2020.05.043","article-title":"Distinguishing proportionate and disproportionate subtypes in functional mitral regurgitation and left ventricular systolic dysfunction","volume":"14","author":"Grayburn","year":"2021","journal-title":"JACC Cardiovasc Imaging."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC guidelines for the diagnosis treatment of acute chronic heart failure: the task force for the diagnosis treatment of acute chronic heart failure of the european society of cardiology (ESC)developed with the special contribution of the heart failure association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J."},{"key":"B13","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/S1388-9842(03)00105-3","article-title":"Increased exercise ejection fraction and reversed remodeling after long-term treatment with metoprolol in congestive heart failure: a randomized, stratified, double-blind, placebo-controlled trial in mild to moderate heart failure due to ischemic or idiopathic dilated cardiomyopathy","volume":"5","author":"Waagstein","year":"2003","journal-title":"Eur J Heart Fail."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1161\/01.CIR.0000054165.93055.42","article-title":"Prevention of heart failure in patients in the heart outcomes prevention evaluation (HOPE) study","volume":"107","author":"Arnold","year":"2003","journal-title":"Circulation."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1016\/S0002-9149(99)00059-4","article-title":"Effects of carvedilol on left ventricular mass, chamber geometry, and mitral regurgitation in chronic heart failure","volume":"83","author":"Lowes","year":"1999","journal-title":"Am J Cardiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1002\/clc.4960211208","article-title":"The impact of beta-receptor blocker addition to high-dose angiotensin-converting enzyme inhibitor-nitrate therapy in heart failure","volume":"21","author":"Levine","year":"1998","journal-title":"Clin Cardiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.1161\/CIRCULATIONAHA.118.037077","article-title":"Angiotensin receptor neprilysin inhibitor for functional mitral regurgitation","volume":"139","author":"Kang","year":"2019","journal-title":"Circulation."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e12435","DOI":"10.1111\/1755-5922.12435","article-title":"The reverse remodeling response to sacubitril\/valsartan therapy in heart failure with reduced ejection fraction","volume":"36","author":"Martens","year":"2018","journal-title":"Cardiovasc Ther."},{"key":"B19","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1016\/j.jchf.2017.06.015","article-title":"Evolution of functional mitral regurgitation and prognosis in medically managed heart failure patients with reduced ejection fraction","volume":"5","author":"Nasser","year":"2017","journal-title":"JACC Heart Fail."},{"key":"B20","volume-title":"Relationship Between Residual Mitral Regurgitation and Clinical and Functional Outcomes in the COAPT Trial","author":"Kar","year":"2019"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2507","DOI":"10.1093\/eurheartj\/ehr311","article-title":"Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiography substudy","volume":"32","author":"Tardif","year":"2011","journal-title":"Eur Heart J."},{"key":"B22","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1161\/CIRCULATIONAHA.120.052926","article-title":"how should we sequence the treatments for heart failure and a reduced ejection fraction?: a redefinition of evidence-based medicine","volume":"143","author":"McMurray","year":"2021","journal-title":"Circulation."},{"key":"B24","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1093\/ehjci\/jev352","article-title":"Echocardiographic study group of the italian society of cardiology (SIC). Role of cardiac dyssynchrony and resynchronization therapy in functional mitral regurgitation","volume":"17","author":"Spartera","year":"2016","journal-title":"Eur Heart J Cardiovasc Imaging."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1056\/NEJMoa050496","article-title":"The effect of cardiac resynchronization on morbidity and mortality in heart failure","volume":"352","author":"Cleland","year":"2005","journal-title":"N Engl J Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1056\/NEJMoa013168","article-title":"Multicenter InSync randomized clinical evaluation. cardiac resynchronization in chronic heart failure","volume":"346","author":"Abraham","year":"2002","journal-title":"N Engl J Med."},{"key":"B27","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/S1062-1458(01)00399-3","article-title":"Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay","volume":"344","author":"Cazeau","year":"2001","journal-title":"N Engl J Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1093\/ejechocard\/jep184","article-title":"Persistence of secondary mitral regurgitation and response to cardiac resynchronization therapy","volume":"11","author":"Cabrera-Bueno","year":"2010","journal-title":"Eur J Echocardiogr."},{"key":"B29","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1093\/europace\/eur047","article-title":"Impact of cardiac resynchronization therapy on the severity of mitral regurgitation","volume":"13","author":"Di","year":"2011","journal-title":"Europace."},{"key":"B30","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1161\/CIRCIMAGING.111.966580","article-title":"Impact of mitral regurgitation on reverse remodeling and outcome in patients undergoingcardiac resynchronization therapy","volume":"5","author":"Verhaert","year":"2012","journal-title":"Circ Cardiovasc Imaging."},{"key":"B31","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1161\/CIRCULATIONAHA.110.009803","article-title":"Cardiac resynchronization therapy as a therapeutic option in patients with moderate-severe functional mitral regurgitation and high operative risk","volume":"124","author":"van","year":"2011","journal-title":"Circulation."},{"key":"B32","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.amjcard.2009.03.060","article-title":"Long-term effect of cardiac resynchronization therapy on functional mitral valve regurgitation","volume":"104","author":"Sitges","year":"2009","journal-title":"Am J Cardiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1093\/eurheartj\/ehi558","article-title":"Contractile response and mitral regurgitation after temporary interruption of long-term cardiac resynchronization therapy","volume":"27","author":"Brandt","year":"2006","journal-title":"Eur Heart J."},{"key":"B34","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/S0735-1097(03)00709-5","article-title":"Cardiac resynchronization therapy can reverse abnormal myocardial strain distribution in patients with heart failure and left bundle branch block","volume":"42","author":"Breithardt","year":"2003","journal-title":"J Am Coll Cardiol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1016\/S0735-1097(02)02937-6","article-title":"Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure","volume":"41","author":"Breithardt","year":"2003","journal-title":"J Am Coll Cardiol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1161\/CIRCHEARTFAILURE.112.000112","article-title":"Mechanistic features associated with improvement in mitral regurgitation after cardiac resynchronization therapy and their relation to long-term patient outcome","volume":"6","author":"Onishi","year":"2013","journal-title":"Circ Heart Fail."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1093\/ehjci\/jez072","article-title":"Left ventricular remodelling and change in left ventricular global longitudinal strain after cardiac resynchronization therapy: prognostic implications","volume":"20","author":"van","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging."},{"key":"B38","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1161\/CIRCULATIONAHA.119.039612","article-title":"Contrasting effects of pharmacological, procedural, and surgical interventions on proportionate and disproportionate functional mitral regurgitation in chronic heart failure","volume":"140","author":"Packer","year":"2019","journal-title":"Circulation."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1474","DOI":"10.1016\/j.jacc.2011.06.032","article-title":"Evidence of atrial functional mitral regurgitation due to atrial fibrillation: reversal with arrhythmia control","volume":"58","author":"Gertz","year":"2011","journal-title":"J Am Coll Cardiol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1016\/j.jcmg.2019.04.022","article-title":"The detrimental effect of RA pacing on LA function and clinical outcome in cardiac resynchronization therapy","volume":"13","author":"Martens","year":"2020","journal-title":"JACC Cardiovasc Imaging."},{"key":"B41","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1093\/ejechocard\/jeq010","article-title":"Atrial asynchrony and function before and after electrical cardioversion for persistent atrial fibrillation","volume":"11","author":"Dell'Era","year":"2010","journal-title":"Eur J Echocardiogr."},{"key":"B42","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1056\/NEJMoa1707855","article-title":"Catheter ablation for atrial fibrillation with heart failure","volume":"378","author":"Marrouche","year":"2018","journal-title":"N Engl J Med."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1093\/europace\/eut088","article-title":"Catheter ablation in selected patients with depressed left ventricular ejection fraction and persistent atrial fibrillation unresponsive to current cardioversion","volume":"15","author":"Bortone","year":"2013","journal-title":"Europace."},{"key":"B44","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1002\/ehf2.13160","article-title":"Impact of catheter ablation for atrial fibrillation on cardiac disorders in patients with coexisting heart failure","volume":"8","author":"Kawaji","year":"2021","journal-title":"ESC Heart Fail."},{"key":"B45","doi-asserted-by":"publisher","first-page":"596491","DOI":"10.3389\/fcvm.2020.596491","article-title":"Catheter ablation of atrial fibrillation in patients with functional mitral regurgitation and left ventricular systolic dysfunction","volume":"7","author":"Wu","year":"2020","journal-title":"Front Cardiovasc Med."},{"key":"B46","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1253\/circj.66.913","article-title":"Impact of atrial fibrillation on tricuspid and mitral annular dilatation and valvular regurgitation","volume":"66","author":"Zhou","year":"2002","journal-title":"Circ J."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1016\/S0002-9149(98)00567-0","article-title":"Increased prevalence of significant tricuspid regurgitation in patients with transvenous pacemakers leads","volume":"82","author":"Paniagua","year":"1998","journal-title":"Am J Cardiol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1016\/0002-8703(82)90051-5","article-title":"Acute and long-term effects of captopril on left and right ventricular volumes and function in chronic heart failure","volume":"104","author":"Massie","year":"1982","journal-title":"Am Heart J."},{"key":"B49","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/S0002-9149(97)00874-6","article-title":"Effects of carvedilol on right ventricular function in chronic heart failure","volume":"81","author":"Quaife","year":"1998","journal-title":"Am J Cardiol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"2883","DOI":"10.1111\/jce.14707","article-title":"Improvement in tricuspid regurgitation following catheter ablation of atrial fibrillation","volume":"31","author":"Markman","year":"2020","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1186\/s13019-020-01336-3","article-title":"Catheter ablation or surgical therapy in moderate-severe tricuspid regurgitation caused by long-standing persistent atrial fibrillation. Propensity score analysis","volume":"15","author":"Wang","year":"2020","journal-title":"J Cardiothorac Surg."},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab395.","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","author":"Vahanian","year":"2021","journal-title":"Eur Heart J"},{"key":"B53","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/j.jcmg.2020.12.015","article-title":"Impact of right ventricular dysfunction on outcomes after transcatheter edge-to-edge repair for secondary mitral regurgitation","volume":"14","author":"Karam","year":"2021","journal-title":"JACC Cardiovasc Imaging."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1016\/j.jcin.2020.02.028","article-title":"Value of echocardiographic right ventricular and pulmonary pressure assessment in predicting transcatheter tricuspid repair outcome","volume":"13","author":"Karam","year":"2020","journal-title":"JACC Cardiovasc Interv."},{"key":"B55","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/S0735-1097(20)31739-3","article-title":"Impact of proportionality of secondary mitral regurgitation on outcome after transcatheter mitral valve repair","volume":"14","author":"Orban","year":"2021","journal-title":"JACC Cardiovasc Imaging."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1016\/j.jcin.2019.04.018","article-title":"Impact of transcatheter tricuspid valve repair for severe tricuspid regurgitation on kidney and liver function","volume":"12","author":"Karam","year":"2019","journal-title":"JACC Cardiovasc Interv."},{"key":"B57","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1016\/j.jcin.2019.10.023","article-title":"Combined tricuspid and mitral versus isolated mitral valve repair for severe MR and TR: an analysis from the TriValve and TRAMI registries","volume":"13","author":"Mehr","year":"2020","journal-title":"JACC Cardiovasc Interv."},{"key":"B58","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1001\/jamacardio.2019.5323","article-title":"Association of clinical outcomes with left ventricular assist device use by bridge to transplant or destination therapy intent: the multicenter study of MagLev technology in patients undergoing mechanical circulatory support therapy with HeartMate 3 (MOMENTUM 3) randomized clinical trial","volume":"5","author":"Goldstein","year":"2020","journal-title":"JAMA Cardiol."},{"key":"B59","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1001\/jamacardio.2019.5323","article-title":"Destination therapy intent: the multicenter study of MagLev technology in patients undergoing mechanical circulatory support therapy with HeartMate 3 (MOMENTUM 3) randomized clinical trial","volume":"5","author":"Goldstein","year":"2020","journal-title":"JAMA Cardiol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.echo.2010.12.022","article-title":"Echocardiographic findings in stable outpatients with properly functioning HeartMate II left ventricular assist devices","volume":"24","author":"Topilsky","year":"2011","journal-title":"J Am Soc Echocardiogr."},{"key":"B61","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1093\/ejcts\/ezz098","article-title":"2019 EACTS expert consensus on long-term mechanical circulatory support","volume":"56","author":"Potapov","year":"2019","journal-title":"Eur J Cardiothorac Surg."},{"key":"B62","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.healun.2020.03.003","article-title":"Impact of left ventricular assist device implantation on mitral regurgitation: an analysis from the MOMENTUM 3 trial","volume":"39","author":"Kanwar","year":"2020","journal-title":"J Heart Lung Transplant."},{"key":"B63","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.healun.2012.12.018","article-title":"Impact of continuous-flow left ventricular assist device support on right ventricular function","volume":"32","author":"Morgan","year":"2013","journal-title":"J Heart Lung Transplant."},{"key":"B64","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1093\/ejcts\/ezaa294","article-title":"Clinical impact and 'natural' course of uncorrected tricuspid regurgitation after implantation of a left ventricular assist device: an analysis of the European registry for patients with mechanical circulatory support (EUROMACS)","volume":"59","author":"Veen","year":"2021","journal-title":"Eur J Cardiothorac Surg."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.713658\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T04:36:59Z","timestamp":1635136619000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.713658\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":64,"alternative-id":["10.3389\/fcvm.2021.713658"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.713658","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]},"article-number":"713658"}}