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The study evaluates TRF’s ability to predict the future need for aortic valve surgery in CAMR patients.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/total-regurgitant-fraction-to-predict-aortic-valve-surgery-in-patients-with-concomitant-aortic-and-mitral-regurgitation/416565/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/total-regurgitant-fraction-to-predict-aortic-valve-surgery-in-patients-with-concomitant-aortic-and-mitral-regurgitation/416565.png","ImageObject",300,407,{"name":42,"@type":43},"Ben ","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What clinical problem does the study address in CAMR patients?","Question",{"text":63,"@type":64},"CAMR is associated with poorer outcomes, but prognostic assessment of aortic regurgitation does not account for mitral regurgitation magnitude. The study targets the need for improved risk prediction for future aortic valve surgery.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were patients and outcomes assessed?",{"text":68,"@type":64},"Patients with CAMR and prior CMR studies were retrospectively recruited. Surgery indications were tracked during follow-up to evaluate whether TRF could predict future need for surgery.",{"name":70,"@type":61,"acceptedAnswer":71},"What was the key finding about TRF compared with aortic regurgitant fraction (ARF)?",{"text":72,"@type":64},"In follow-up, a TRF \u003C 40% group had lower surgery-indication development than the ARF \u003C 29% comparison. In multivariate analysis, a binary TRF model showed a substantially high hazard ratio for developing surgery indications.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},416565,1790716233,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":111,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":118,"preview_page_count":4},2336478951081,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Original Article Cardiol Res. 2025;16(6):525-532  \nTotal Regurgitant Fraction to Predict Aortic Valve Surgery in Patients With Concomitant Aortic and Mitral  \nRegurgitation  \nAlvaro Montesa, Alberto Cecconia, i, Albert Teisb, Juan Lacalzada-Almeidac, Beatriz Lopez Melgara, Paloma Caballerod, Susana Hernandez Munizd, Carmen Benavidesd, Dafne Vilianie, Mauro Di Silvestrec, Cesar Jimenez Mendezf, Maria Manuela Izquierdo-Gomezc,  \nFlor Baeza Garzonc, Claudia Escabiab, Fernando Alfonsoa, g, h, Luis Jesus Jimenez-Borregueroa, f  \nAbstract  \nBackground: Concomitant aortic and mitral regurgitation (CAMR) is associated with poorer outcome compared with isolated aortic regurgitation (AR) . Current prognostic assessment ofAR does not include the magnitude of mitral regurgitation (MR) . Cardiac magnetic resonance (CMR) can integrate volumetric data to obtain a novel combined parameter, total regurgitant fraction (TRF), which could have the potential ability to measure the combined effects ofAR and MR on left ventricle (LV) overload. The aim of our study was to explore the usefulness of TRF in predicting the future need of aortic valve surgery in patients with CAMR.  \nMethods and Results: Patients with CAMR and prior CMR studies were retrospectively recruited. A total of 45 patients were included, of whom 10 (22%) developed surgery indications. At the median follow-up time point (3.2 years), survival without surgery indication was 95% in the group with TRF \u003C 40% compared to 90% in the group with aortic regurgitant fraction (ARF) \u003C 29%. In contrast, 67% of patients with TRF ≥ 40% developed surgery indications after 3.2 years compared to 55% of patients with ARF ≥ 29% . In the multivariate analysis, the model including binary TRF had the highest hazard ratio of 13.846 (2.822 to 67.939, P = 0.001) .  \nManuscript submitted June 29, 2025, accepted September 27, 2025  \nPublished online December 20, 2025  \naCardiology Department, University Hospital of La Princesa, Madrid, Spain bCardiology Department, Institut del Cor. Hospital Germans Trias i Pujol Hospital, Badalona, Spain  \ncCardiology Department, University Hospital of the Canaries, Santa Cruz De Tenerife, Spain  \ndRadiology Department, University Hospital of La Princesa, Madrid, Spain eCardiology Department, Santa Chiara Hospital in Trento, Trento, Italy fCardiology Department, University Hospital Puerta del Mar, Cadiz, Spain gCentro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain  \nhIIS-IP, Universidad Autonoma de Madrid, Madrid, Spain  \niCorresponding Author: Alberto Cecconi, Cardiology Department, University  \nHospital of La Princesa, Madrid, Spain. Email: [albertocecconi@hotmail.com](albertocecconi@hotmail.com)  \ndoi: [https://doi.org/10.14740/cr2068](https://doi.org/10.14740/cr2068)  \nConclusions: TRF is a promising CMR parameter that could improve the prediction of the need for surgery in patients with CAMR. Further studies with larger populations should be performed to confirm these findings.  \nKeywords: Aortic regurgitation; Mitral regurgitation; Cardiac magnetic resonance; Total regurgitation fraction  \nIntroduction  \nChronic aortic regurgitation (AR) and mitral regurgitation (MR) are common valvular heart diseases that can lead to heart failure. Both conditions are associated with left ventricle (LV) enlargement and dysfunction secondary to diastolic volume overload. Concomitant aortic and mitral regurgitation (CAMR) is not uncommon, with a prevalence of moderate or severe MR in 14-25% of patients with moderate or severe AR. This coexistence is associated with poorer outcomes compared with isolated AR [1, 2] .  \nWhen both regurgitations are concomitant, the overload of the LV is conditioned by the excess of volume produced by the sum of the aortic regurgitant volume (ARV) and mitral regurgitant volume (MRV) . However, current prognostic assessment of AR does not consider the presence and magnitude of concomitant MR. As a result, there ar","cbCaitRgBOi51ymK","https://ap.wps.com/l/cbCaitRgBOi51ymK","pdf",1486993,"English","# Abstract\n# Background\n# Methods and Results\n# Conclusions\n# Keywords\n# Introduction","[{\"question\":\"What clinical problem does the study address in CAMR patients?\",\"answer\":\"CAMR is associated with poorer outcomes, but prognostic assessment of aortic regurgitation does not account for mitral regurgitation magnitude. The study targets the need for improved risk prediction for future aortic valve surgery.\"},{\"question\":\"How were patients and outcomes assessed?\",\"answer\":\"Patients with CAMR and prior CMR studies were retrospectively recruited. Surgery indications were tracked during follow-up to evaluate whether TRF could predict future need for surgery.\"},{\"question\":\"What was the key finding about TRF compared with aortic regurgitant fraction (ARF)?\",\"answer\":\"In follow-up, a TRF \\u003c 40% group had lower surgery-indication development than the ARF \\u003c 29% comparison. In multivariate analysis, a binary TRF model showed a substantially high hazard ratio for developing surgery indications.\"}]","Total Regurgitant Fraction to Predict Aortic Valve Surgery in Patients With Concomitant Aortic and Mitral Regurgitation | PDF",1790605867]