{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:20:50Z","timestamp":1791883250848,"version":"4.3.4"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Surgical correction of severe mitral regurgitation (MR) can reverse left ventricular (LV) remodeling in patients with mitral valve prolapse (MVP). However, whether this process is similar to the case in Barlow\u2019s Disease (BD) and Fibro-elastic Deficiency (FED) is currently unknown. The aim of this study is to evaluate post-operative LV reverse remodeling and function in patients with BD versus FED. In this study, 100 MVP patients (BD = 37 and FED = 63) with severe MR who underwent mitral valve surgery at three Belgian centers were retrospectively included. Transthoracic echocardiography was used to assess MR severity, LV volumes and function before surgery and 6 months thereafter. Baseline MR severity, LV ejection fraction (LVEF), indexed LV end-diastolic (LVEDVi) and end-systolic volumes (LVESVi) were not different between the groups. After a median follow-up of 278 days, there was a similar decrease in LVEDVi, but a trend towards a smaller decrease in LVESVi in BD compared to FED (\u22123.0 \u00b1 11.2 mL\/m2 vs. \u22125.3 \u00b1 9.0 mL\/m2; p = 0.154). This resulted in a significantly larger decrease in LVEF in BD (\u22128.3 \u00b1 9.6%) versus FED (\u22123.9 \u00b1 6.9%) after adjusting for baseline LVEF (p &lt; 0.001) and type of surgical intervention (p = 0.01). These findings suggest that LV (reverse) remodeling in BD could be affected by other mechanisms beyond volume overload, potentially involving concomitant cardiomyopathy.<\/jats:p>","DOI":"10.3390\/jcdd11030071","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T05:42:46Z","timestamp":1708494166000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Mitral Valve Surgery for Mitral Regurgitation Results in Reduced Left Ventricular Ejection Fraction in Barlow\u2019s Disease as Compared with Fibro-Elastic Deficiency"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9679-0996","authenticated-orcid":false,"given":"Lobke L.","family":"Pype","sequence":"first","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital, 2650 Edegem, Belgium"},{"name":"GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe B.","family":"Bertrand","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Oost-Limburg, 3600 Genk, Belgium"},{"name":"Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Debonnaire","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sint-Jan Hospital Bruges, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5615-3191","authenticated-orcid":false,"given":"Sebastiaan","family":"Dhont","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Oost-Limburg, 3600 Genk, Belgium"},{"name":"Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boukje","family":"Hoekman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sint-Jan Hospital Bruges, 8000 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard P.","family":"Paelinck","sequence":"additional","affiliation":[{"name":"GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium"},{"name":"Department of Cardiac Surgery, Antwerp University Hospital, 2650 Edegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0456-9400","authenticated-orcid":false,"given":"Dina","family":"De Bock","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Antwerp University Hospital, 2650 Edegem, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein","family":"Heidbuchel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital, 2650 Edegem, Belgium"},{"name":"GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emeline M.","family":"Van Craenenbroeck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital, 2650 Edegem, Belgium"},{"name":"GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4661-4732","authenticated-orcid":false,"given":"Caroline M.","family":"Van De Heyning","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital, 2650 Edegem, Belgium"},{"name":"GENCOR Research Group, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1056\/NEJM199907013410101","article-title":"Prevalence and clinical outcome of mitral-valve prolapse","volume":"341","author":"Freed","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1161\/CIRCULATIONAHA.113.006702","article-title":"Epidemiology and pathophysiology of mitral valve prolapse: New insights into disease progression, genetics, and molecular basis","volume":"129","author":"Delling","year":"2014","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"862044","DOI":"10.3389\/fcvm.2022.862044","article-title":"Left Ventricular Remodeling in Non-syndromic Mitral Valve Prolapse: Volume Overload or Concomitant Cardiomyopathy?","volume":"9","author":"Pype","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1053\/j.semtcvs.2007.04.002","article-title":"Etiologic classification of degenerative mitral valve disease: Barlow\u2019s disease and fibroelastic deficiency","volume":"19","author":"Anyanwu","year":"2007","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1093\/eurheartj\/ehq222","article-title":"Degenerative mitral valve regurgitation: Best practice revolution","volume":"31","author":"Adams","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/j.1540-8175.2011.01544.x","article-title":"Classic mitral valve prolapse causes enlargement in left ventricle even in the absence of significant mitral regurgitation","volume":"29","author":"Yiginer","year":"2012","journal-title":"Echocardiography"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1017\/S1047951113001042","article-title":"Cardiomyopathy in young adults with classic mitral valve prolapse","volume":"24","author":"Malev","year":"2014","journal-title":"Cardiol. Young"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.echo.2020.01.016","article-title":"Mitral Valve Prolapse Patients with Less than Moderate Mitral Regurgitation Exhibit Early Cardiac Chamber Remodeling","volume":"33","author":"Yang","year":"2020","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_9","first-page":"e35","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"ref_10","first-page":"524","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"75","author":"Vahanian","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e171","DOI":"10.1093\/ehjci\/jeab253","article-title":"Multi-modality imaging assessment of native valvular regurgitation: An EACVI and ESC council of valvular heart disease position paper","volume":"23","author":"Lancellotti","year":"2022","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s12471-021-01575-6","article-title":"Mitral prolapsing volume is associated with increased cardiac dimensions in patients with mitral annular disjunction","volume":"30","author":"Luyten","year":"2021","journal-title":"Neth. Heart J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1080\/24748706.2019.1639870","article-title":"Reverse Left Ventricular Remodeling after Surgery in Primary Mitral Regurgitation: A Volume-Related Phased Process","volume":"3","author":"Topilsky","year":"2019","journal-title":"Struct. Heart"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1093\/ehjci\/jead093","article-title":"Determinants of post-operative left ventricular dysfunction in degenerative mitral regurgitation","volume":"24","author":"Althunayyan","year":"2023","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1016\/0735-1097(94)90151-1","article-title":"Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: Results and clinical implications","volume":"24","author":"Tajik","year":"1994","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1161\/01.CIR.91.4.1022","article-title":"Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis","volume":"91","author":"Schaff","year":"1995","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s12968-023-00946-9","article-title":"Cardiac reverse remodeling in primary mitral regurgitation: Mitral valve replacement vs. mitral valve repair","volume":"25","author":"Craven","year":"2023","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_18","first-page":"1763","article-title":"Replacement Myocardial Fibrosis in Patients with Mitral Valve Prolapse: Relation to Mitral Regurgitation, Ventricular Remodeling and Arrhythmia","volume":"18","author":"Huttin","year":"2021","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1136\/heartjnl-2017-312420","article-title":"Genetics of syndromic and non-syndromic mitral valve prolapse","volume":"104","author":"Rimbert","year":"2018","journal-title":"Heart"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1136\/jmedgenet-2019-106715","article-title":"Identification of known and unknown genes associated with mitral valve prolapse using an exome slice methodology","volume":"57","author":"Hiemstra","year":"2020","journal-title":"J. Med. Genet."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.jacc.2020.06.029","article-title":"Presentation and Outcome of Arrhythmic Mitral Valve Prolapse","volume":"76","author":"Essayagh","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_22","first-page":"573","article-title":"Resolving the Disproportionate Left Ventricular Enlargement in Mitral Valve Prolapse Due to Barlow Disease: Insights From Cardiovascular Magnetic Resonance","volume":"14","author":"Kitkungvan","year":"2020","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.amjcard.2021.07.019","article-title":"Influence of Prolapse Volume in Mitral Valve Prolapse","volume":"157","author":"Levy","year":"2021","journal-title":"Am. J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1476-7120-11-46","article-title":"Assessment of left ventricular volumes and primary mitral regurgitation severity by 2D echocardiography and cardiovascular magnetic resonance","volume":"11","author":"Magne","year":"2013","journal-title":"Cardiovasc. Ultrasound"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/3\/71\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:02:02Z","timestamp":1760104922000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/11\/3\/71"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,21]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jcdd11030071"],"URL":"https:\/\/doi.org\/10.3390\/jcdd11030071","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,21]]}}}