{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:05:42Z","timestamp":1788822342423,"version":"build-2803163510"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Cardiovasc Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    : Mitral annular disjunction (MAD) may accompany mitral valve prolapse (MVP) and is linked to ventricular arrhythmias. Its impact on global cardiac performance (specifically cardiac index (CI) and output (CO)), remains incompletely defined. Cardiac MRI (CMR) allows precise measurement of MAD, assessment of mitral annular dynamics, and detection of myocardial fibrosis via late gadolinium enhancement (LGE). We investigated both CMR and TTE metrics in patients with varying degrees of MAD compared to MVP-only.\n                    <jats:italic>Methods and results<\/jats:italic>\n                    : Fifty-six patients who underwent CMR and TTE (mean age 61, 33 female) were divided into MAD \u22652 mm and MVP (the \u201cMAD + MVP\u201d group, n\u2009=\u200941) or MVP-only (n\u2009=\u200915). MAD was classified as &lt;5 mm, \u22655 mm, and \u2265\u200910 mm in peak systole after excluding pseudo-MAD. LV volume, stroke volume, ejection fraction, cardiac output (CO), cardiac index (CI), mitral regurgitation (MR), and LGE were assessed. Any MAD was associated with lower CI versus MVP-only (p\u2009=\u20090.03). MAD \u22655 mm and MAD \u2265\u200910 mm showed reduced CO (p\u2009=\u20090.04 and 0.04, respectively) and CI (p\u2009=\u20090.04 and 0.03, respectively) versus MVP-only. LGE was more frequent in MAD \u2265\u200910 mm than in MAD &lt;\u200910 mm (p\u2009=\u20090.028). MR incidence, volume, or fraction did not differ across groups. TTE showed agreement with CMR in MAD detection and quantification (p\u2009=\u20090.269), with minimal inter-observer variability (p\u2009&lt;\u20090.001).\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : MAD is associated with impaired cardiac performance independent of MR and with increased myocardial fibrosis in severe cases. These findings suggest heightened electromechanical stress in MAD compared to MVP-only, which needs to be clinically correlated. TTE reliably detects and quantifies MAD, supporting its use alongside CMR for assessment of MAD.\n                  <\/jats:p>","DOI":"10.1007\/s10554-026-03709-6","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T02:27:24Z","timestamp":1777256844000},"page":"1591-1600","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mitral annular disjunction and mitral valve prolapse: echocardiographic-MRI insights into cardiac function"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6785-413X","authenticated-orcid":false,"given":"Max D.","family":"King","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C.","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Karimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson N.","family":"Owen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baskaran","family":"Sundaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behzad B.","family":"Pavri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"issue":"9","key":"3709_CR1","doi-asserted-by":"publisher","first-page":"295","DOI":"10.31083\/j.rcm2309295","volume":"23","author":"P Niarchou","year":"2022","unstructured":"Niarchou P, Prappa E, Liatakis I, Vlachos K, Chatziantoniou A, Nyktari E, Letsas KP (2022) Mitral valve prolapse and mitral annular disjunction arrhythmic syndromes: diagnosis, risk stratification and management. 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