{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:51:59Z","timestamp":1791172319379,"version":"4.1.0"},"reference-count":109,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal-of-cardiology.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiology"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.jjcc.2026.09.004","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:51:00Z","timestamp":1789141860000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mitral valve prolapse: New clinical and scientific insights in 2026"],"prefix":"10.1016","author":[{"given":"Masashi","family":"Yamaguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radha","family":"Madhyastha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Furukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Kaikita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomi","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jjcc.2026.09.004_bb0005","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":"10.1016\/j.jjcc.2026.09.004_bb0010","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13206160","article-title":"Echocardiographic assessment of mitral valve prolapse prevalence before and after the year 1999: a systematic review","volume":"13","author":"Sonaglioni","year":"2024","journal-title":"J Clin Med"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0015","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1161\/CIRCULATIONAHA.118.034075","article-title":"Mitral valve prolapse, ventricular arrhythmias, and sudden death","volume":"140","author":"Basso","year":"2019","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0020","doi-asserted-by":"crossref","first-page":"3121","DOI":"10.1093\/eurheartj\/ehad491","article-title":"Arrhythmic mitral valve prolapse and mitral annular disjunction: pathophysiology, risk stratification, and management","volume":"44","author":"Essayagh","year":"2023","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0025","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/S0140-6736(18)30473-2","article-title":"Outcome and undertreatment of mitral regurgitation: a community cohort study","volume":"391","author":"Dziadzko","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0030","doi-asserted-by":"crossref","first-page":"2844","DOI":"10.1016\/j.jacc.2015.10.018","article-title":"Randomized comparison of percutaneous repair and surgery for mitral regurgitation: 5-year results of EVEREST II","volume":"66","author":"Feldman","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0035","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/S0735-1097(98)90059-6","article-title":"Reconsideration of echocardiographic standards for mitral valve prolapse: lack of association between leaflet displacement isolated to the apical four chamber view and independent echocardiographic evidence of abnormality","volume":"11","author":"Levine","year":"1988","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0040","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1161\/01.CIR.80.3.589","article-title":"Three-dimensional echocardiographic reconstruction of the mitral valve, with implications for the diagnosis of mitral valve prolapse","volume":"80","author":"Levine","year":"1989","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0045","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1161\/01.CIR.75.4.756","article-title":"The relationship of mitral annular shape to the diagnosis of mitral valve prolapse","volume":"75","author":"Levine","year":"1987","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0050","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.echo.2013.08.025","article-title":"A new definition for an old entity: improved definition of mitral valve prolapse using three-dimensional echocardiography and color-coded parametric models","volume":"27","author":"Addetia","year":"2014","journal-title":"J Am Soc Echocardiogr"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0055","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1161\/hc4601.099489","article-title":"Activated interstitial myofibroblasts express catabolic enzymes and mediate matrix remodeling in myxomatous heart valves","volume":"104","author":"Rabkin","year":"2001","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0060","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":"10.1016\/j.jjcc.2026.09.004_bb0065","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S1054-8807(98)00021-0","article-title":"Correlation between clinical and histologic patterns of degenerative mitral valve insufficiency: a histomorphometric study of 130 excised segments","volume":"8","author":"Fornes","year":"1999","journal-title":"Cardiovasc Pathol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0070","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0735-1097(03)00626-0","article-title":"Glycosaminoglycan profiles of myxomatous mitral leaflets and chordae parallel the severity of mechanical alterations","volume":"42","author":"Grande-Allen","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0075","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1161\/CIRCULATIONAHA.108.805911","article-title":"Evolving concepts of cardiac valve dynamics: the continuum of development, functional structure, pathobiology, and tissue engineering","volume":"118","author":"Schoen","year":"2008","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0080","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1093\/ehjci\/jeae031","article-title":"Mitral valve early systolic billowing induces following annular expansion and leaflet augmentation in Barlow\u2019s disease: sequential analysis using 3D echocardiography","volume":"25","author":"Amano","year":"2024","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0085","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1172\/JCI200422715","article-title":"TGF-\u03b2\u2013dependent pathogenesis of mitral valve prolapse in a mouse model of Marfan syndrome","volume":"114","author":"Ng","year":"2004","journal-title":"J Clin Invest"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0090","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1161\/01.RES.0000260181.19449.95","article-title":"Perturbations of vascular homeostasis and aortic valve abnormalities in fibulin-4 deficient mice","volume":"100","author":"Hanada","year":"2007","journal-title":"Circ Res"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0095","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1161\/CIRCRESAHA.110.221358","article-title":"Elastin haploinsufficiency results in progressive aortic valve malformation and latent valve disease in a mouse model","volume":"107","author":"Hinton","year":"2010","journal-title":"Circ Res"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0100","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3390\/jcdd2030233","article-title":"MVP-associated filamin A mutations affect FlnA-PTPN12 (PTP-PEST) interactions","volume":"2","author":"Duval","year":"2015","journal-title":"J Cardiovasc Dev Dis"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0105","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/j.mayocp.2018.11.028","article-title":"A novel truncating variant in FLNC-encoded filamin C may serve as a proarrhythmic genetic substrate for arrhythmogenic bileaflet mitral valve prolapse syndrome","volume":"94","author":"Bains","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0110","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1038\/nature14670","article-title":"Mutations in DCHS1 cause mitral valve prolapse","volume":"525","author":"Durst","year":"2015","journal-title":"Nature"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0115","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.aax0290","article-title":"Primary cilia defects causing mitral valve prolapse","volume":"11","author":"Toomer","year":"2019","journal-title":"Sci Transl Med"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0120","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.adc9606","article-title":"Decreased serotonin transporter activity in the mitral valve contributes to progression of degenerative mitral regurgitation","volume":"15","author":"Castillero","year":"2023","journal-title":"Sci Transl Med"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0125","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1161\/CIRCULATIONAHA.114.012594","article-title":"Familial clustering of mitral valve prolapse in the community","volume":"131","author":"Delling","year":"2015","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0130","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1093\/eurheartj\/ehac049","article-title":"Genome-wide association study reveals novel genetic loci: a new polygenic risk score for mitral valve prolapse","volume":"43","author":"Roselli","year":"2022","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0135","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.872288","article-title":"The role of transforming growth factor-\u03b2 signaling in myxomatous mitral valve degeneration","volume":"9","author":"Tang","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0140","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.bbrc.2014.03.014","article-title":"Losartan inhibits endothelial-to-mesenchymal transformation in mitral valve endothelial cells by blocking transforming growth factor-\u03b2-induced phosphorylation of ERK","volume":"446","author":"Wylie-Sears","year":"2014","journal-title":"Biochem Biophys Res Commun"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0145","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.1161\/CIR.0000000000001254","article-title":"Unraveling the mechanisms of valvular heart disease to identify medical therapy targets: a scientific statement from the American Heart Association","volume":"150","author":"Small","year":"2024","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0150","article-title":"Differential microRNA expression profile in myxomatous mitral valve prolapse and fibroelastic deficiency valves","volume":"17","author":"Chen","year":"2016","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0155","doi-asserted-by":"crossref","DOI":"10.3390\/ijms22042102","article-title":"Putative circulating microRNAs are able to identify patients with mitral valve prolapse and severe regurgitation","volume":"22","author":"Songia","year":"2021","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0160","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s12967-018-1429-3","article-title":"Deregulated microRNA and mRNA expression profiles in the peripheral blood of patients with Marfan syndrome","volume":"16","author":"Abu-Halima","year":"2018","journal-title":"J Transl Med"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0165","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1161\/01.CIR.0000028933.34260.09","article-title":"Natural history of asymptomatic mitral valve prolapse in the community","volume":"106","author":"Avierinos","year":"2002","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0170","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1016\/S0735-1097(02)02161-7","article-title":"Mitral valve prolapse in the general population: the benign nature of echocardiographic features in the Framingham Heart Study","volume":"40","author":"Freed","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0175","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/S0735-1097(02)01922-8","article-title":"Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome","volume":"40","author":"Grigioni","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0180","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1093\/eurheartj\/ehq294","article-title":"Prognostic and therapeutic implications of pulmonary hypertension complicating degenerative mitral regurgitation due to flail leaflet: a multicenter long-term international study","volume":"32","author":"Barbieri","year":"2011","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0185","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/j.jacc.2009.06.047","article-title":"Survival implication of left ventricular end-systolic diameter in mitral regurgitation due to flail leaflets a long-term follow-up multicenter study","volume":"54","author":"Tribouilloy","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0190","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/0002-8703(81)90235-0","article-title":"The conduction system in mitral valve prolapse syndrome with sudden death","volume":"101","author":"Bharati","year":"1981","journal-title":"Am Heart J"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0195","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1161\/CIRCULATIONAHA.118.033488","article-title":"Common phenotype in patients with mitral valve prolapse who experienced sudden cardiac death","volume":"138","author":"Hourdain","year":"2018","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0200","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1016\/S0735-1097(99)00474-X","article-title":"Sudden death in mitral regurgitation due to flail leaflet","volume":"34","author":"Grigioni","year":"1999","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0205","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1093\/europace\/euac125","volume":"24","author":"Sabbag","year":"2022","journal-title":"Europace"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0210","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1161\/CIRCULATIONAHA.115.016291","article-title":"Arrhythmic mitral valve prolapse and sudden cardiac death","volume":"132","author":"Basso","year":"2015","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0215","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/j.jcmg.2021.04.029","article-title":"The mitral annular disjunction of mitral valve prolapse: presentation and outcome","volume":"14","author":"Essayagh","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0220","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1161\/CIRCULATIONAHA.120.050214","article-title":"Replacement myocardial fibrosis in patients with mitral valve prolapse: relation to mitral regurgitation, ventricular remodeling, and arrhythmia","volume":"143","author":"Constant Dit Beaufils","year":"2021","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0225","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.116.005030","article-title":"Morphofunctional abnormalities of mitral annulus and arrhythmic mitral valve prolapse","volume":"9","author":"Perazzolo Marra","year":"2016","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0230","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1093\/ehjci\/jez153","article-title":"Anatomy of mitral annulus insights from non-invasive imaging techniques","volume":"20","author":"Faletra","year":"2019","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0235","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/j.jacc.2018.07.070","article-title":"The mitral annulus disjunction arrhythmic syndrome","volume":"72","author":"Dejgaard","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0240","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1161\/01.CIR.55.3.504","article-title":"Quantitation of left ventricular myocardial fiber hypertrophy and interstitial tissue in human hearts with chronically increased volume and pressure overload","volume":"55","author":"Fuster","year":"1977","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0245","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jcmg.2012.09.012","article-title":"Prognostic role of CMR in patients presenting with ventricular arrhythmias","volume":"6","author":"Dawson","year":"2013","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0250","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.jacc.2018.06.048","article-title":"Myocardial fibrosis in patients with primary mitral regurgitation with and without prolapse","volume":"72","author":"Kitkungvan","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0255","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s12968-021-00797-2","article-title":"Myocardial extracellular volume by T1 mapping: a new marker of arrhythmia in mitral valve prolapse","volume":"23","author":"Pavon","year":"2021","journal-title":"J Cardiovasc Magn Reson"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0260","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.122.014963","article-title":"Abnormal mechanics relate to myocardial fibrosis and ventricular arrhythmias in patients with mitral valve prolapse","volume":"16","author":"Nagata","year":"2023","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0265","first-page":"323","article-title":"Interactions between mitral valve and left ventricle analysed by 2D speckle tracking in patients with mitral valve prolapse: one more piece to the puzzle","volume":"18","author":"Huttin","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0270","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1016\/j.jcmg.2016.11.022","article-title":"Functional implication of mitral annular disjunction in mitral valve prolapse: a quantitative dynamic 3D echocardiographic study","volume":"10","author":"Lee","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0275","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jjcc.2024.10.004","article-title":"Usefulness of intraoperative color three-dimensional transesophageal echocardiography for detecting treatable residual mitral regurgitation immediately after mitral valve repair","volume":"85","author":"Okubo","year":"2025","journal-title":"J Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0280","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1007\/s10554-024-03179-8","article-title":"Echocardiographic assessment of left ventricular mechanics in individuals with mitral valve prolapse: a systematic review and meta-analysis","volume":"40","author":"Sonaglioni","year":"2024","journal-title":"Int J Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0285","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1136\/heartjnl-2018-314269","article-title":"Left ventricular mechanical dispersion predicts arrhythmic risk in mitral valve prolapse","volume":"105","author":"Ermakov","year":"2019","journal-title":"Heart"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0290","doi-asserted-by":"crossref","DOI":"10.1002\/clc.24316","article-title":"The association between late gadolinium enhancement by cardiac magnetic resonance and ventricular arrhythmia in patients with mitral valve prolapse: a systematic review and meta-analysis","volume":"47","author":"Tang","year":"2024","journal-title":"Clin Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0295","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1007\/s00330-018-5634-5","article-title":"Cardiac magnetic resonance in patients with mitral valve prolapse: focus on late gadolinium enhancement and T1 mapping","volume":"29","author":"Pradella","year":"2019","journal-title":"Eur Radiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0300","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.jcct.2012.10.007","article-title":"Evaluation of valvular disease by cardiac computed tomography assessment","volume":"6","author":"Buttan","year":"2012","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0305","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1148\/rg.2017170004","article-title":"Fibrous skeleton of the heart: anatomic overview and evaluation of pathologic conditions with CT and MR imaging","volume":"37","author":"Saremi","year":"2017","journal-title":"RadioGraphics"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0310","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1016\/j.jcmg.2020.12.018","article-title":"Role of cardiac CT in pre-procedure planning for transcatheter mitral valve replacement","volume":"14","author":"Ge","year":"2021","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0315","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1001\/jamacardio.2020.1555","article-title":"Hybrid positron emission tomography\/magnetic resonance imaging in arrhythmic mitral valve prolapse","volume":"5","author":"Miller","year":"2020","journal-title":"JAMA Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0320","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.jacc.2013.02.060","article-title":"Malignant bileaflet mitral valve prolapse syndrome in patients with otherwise idiopathic out-of-hospital cardiac arrest","volume":"62","author":"Sriram","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0325","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.jacc.2019.06.032","article-title":"Prognostic implications of left atrial enlargement in degenerative mitral regurgitation","volume":"74","author":"Essayagh","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0330","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.jacc.2018.10.067","article-title":"Long-term implications of atrial fibrillation in patients with degenerative mitral regurgitation","volume":"73","author":"Grigioni","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0335","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1161\/CIRCIMAGING.113.001251","article-title":"Long-term mortality associated with left ventricular dysfunction in mitral regurgitation due to flail leaflets: a multicenter analysis","volume":"7","author":"Tribouilloy","year":"2014","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0340","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.124.040868","article-title":"Disproportionate left ventricular enlargement in mitral valve prolapse: prevalence, predictors, and association with outcomes","volume":"14","author":"Topilsky","year":"2025","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0345","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1136\/heartjnl-2017-312932","article-title":"Mitral valve prolapse and sudden cardiac death: a systematic review and meta-analysis","volume":"105","author":"Nalliah","year":"2019","journal-title":"Heart"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0350","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":"10.1016\/j.jjcc.2026.09.004_bb0355","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1053\/eupc.2001.0186","article-title":"QT dispersion in patients with mitral valve prolapse is related to the echocardiographic degree of the prolapse and mitral leaflet thickness","volume":"3","author":"Zouridakis","year":"2001","journal-title":"Europace"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0360","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2024.101023","article-title":"Impact of sex on severity assessment and cardiac remodeling in primary mitral regurgitation","volume":"3","author":"Altes","year":"2024","journal-title":"JACC Adv"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0365","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.033635","article-title":"Gender and sex differences in the management, intervention, and outcomes of patients with severe primary mitral regurgitation","volume":"13","author":"Waldron","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0370","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.jcmg.2016.02.017","article-title":"Comprehensive imaging in women with organic mitral regurgitation: implications for clinical outcome","volume":"9","author":"Mantovani","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0375","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/HCO.0000000000000150","article-title":"Gender differences in outcomes following cardiac surgery: implications for managing patients with mitral valve disease","volume":"30","author":"Tran","year":"2015","journal-title":"Curr Opin Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0380","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1093\/ehjqcco\/qcaf016","article-title":"Prevalence, progression, and clinical outcomes of mitral valve prolapse: a systematic review and meta-analysis","volume":"11","author":"Melamed","year":"2025","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0385","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.1093\/eurheartj\/ehz314","article-title":"Causes and mechanisms of isolated mitral regurgitation in the community: clinical context and outcome","volume":"40","author":"Dziadzko","year":"2019","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0390","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1016\/j.jcmg.2018.05.014","article-title":"Long-term outcome of active surveillance in severe but asymptomatic primary mitral regurgitation","volume":"11","author":"Zilberszac","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0395","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1056\/NEJM199611073351902","article-title":"Clinical outcome of mitral regurgitation due to flail leaflet","volume":"335","author":"Ling","year":"1996","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0400","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jcmg.2007.12.005","article-title":"Outcomes in mitral regurgitation due to flail leaflets a multicenter European study","volume":"1","author":"Grigioni","year":"2008","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0405","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/S0003-4975(02)03754-2","article-title":"Minimally invasive mitral valve surgery: a 6-year experience with 714 patients","volume":"74","author":"Grossi","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0410","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1016\/j.athoracsur.2014.12.043","article-title":"A population-based analysis of robotic-assisted mitral valve repair","volume":"99","author":"Paul","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0415","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1253\/circj.CJ-20-0135","article-title":"JCS\/JSCS\/JATS\/JSVS 2020 Guidelines on the management of valvular heart disease","volume":"84","author":"Izumi","year":"2020","journal-title":"Circ J"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0420","first-page":"e72","article-title":"2020 ACC\/AHA Guideline for the management of patients with valvular heart disease: 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":"10.1016\/j.jjcc.2026.09.004_bb0425","doi-asserted-by":"crossref","first-page":"4635","DOI":"10.1093\/eurheartj\/ehaf194","article-title":"2025 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"46","author":"Praz","year":"2025","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0430","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1161\/CIRCULATIONAHA.116.023340","article-title":"Twenty-year outcome after mitral repair versus replacement for severe degenerative mitral regurgitation: analysis of a large, prospective, multicenter, international registry","volume":"135","author":"Lazam","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0435","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1001\/jama.2013.8643","article-title":"Association between early surgical intervention vs watchful waiting and outcomes for mitral regurgitation due to flail mitral valve leaflets","volume":"310","author":"Suri","year":"2013","journal-title":"JAMA"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0440","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.jtcvs.2018.02.102","article-title":"Simple versus complex degenerative mitral valve disease","volume":"156","author":"Javadikasgari","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0445","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jtcvs.2007.06.040","article-title":"Durability of mitral valve repair in Barlow disease versus fibroelastic deficiency","volume":"135","author":"Flameng","year":"2008","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0450","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1016\/j.jtcvs.2011.11.016","article-title":"Mitral valve reconstruction in Barlow disease: long-term echographic results and implications for surgical management","volume":"143","author":"Jouan","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0455","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1161\/CIRCULATIONAHA.120.046853","article-title":"Randomized, controlled trial comparing mitral valve repair with leaflet resection versus leaflet preservation on functional mitral stenosis: the CAMRA CardioLink-2 study","volume":"142","author":"Chan","year":"2020","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0460","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.amjcard.2023.12.010","article-title":"Respect versus resect approaches for mitral valve repair: a meta-analysis of reconstructed time-to-event data","volume":"213","author":"Caldonazo","year":"2024","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0465","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.jtcvs.2025.07.047","article-title":"Comparison of myocardial mechanics after mitral valve repair with leaflet preservation versus leaflet resection: a subanalysis of the randomized Canadian Mitral Research Alliance CardioLink-2 trial","volume":"171","author":"Rumman","year":"2026","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0470","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2025.101589","article-title":"Mitral valve repair: optimal annual case volume for surgery","volume":"4","author":"Hameed","year":"2025","journal-title":"JACC Adv"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0475","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1111\/jocs.14799","article-title":"Mitral valve repair with minimally invasive approaches vs sternotomy: a meta-analysis of early and late results in randomized and matched observational studies","volume":"35","author":"S\u00e1","year":"2020","journal-title":"J Card Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0480","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1001\/jama.2023.7800","article-title":"Minithoracotomy vs conventional sternotomy for mitral valve repair: a randomized clinical trial","volume":"329","author":"Akowuah","year":"2023","journal-title":"JAMA"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0485","doi-asserted-by":"crossref","DOI":"10.1093\/ejcts\/ezae426","article-title":"Learning curve of robotic mitral repair: prospective two-centre study of proficiency and clinical outcomes","volume":"66","author":"Sandoval","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0490","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1161\/CIRCULATIONAHA.112.001402","article-title":"Learning minimally invasive mitral valve surgery: a cumulative sum sequential probability analysis of 3895 operations from a single high-volume center","volume":"128","author":"Holzhey","year":"2013","journal-title":"Circulation"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0495","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.jacc.2009.03.079","article-title":"Failure of guideline adherence for intervention in patients with severe mitral regurgitation","volume":"54","author":"Bach","year":"2009","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0500","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1067\/mtc.2001.117277","article-title":"The double-orifice technique in mitral valve repair: a simple solution for complex problems","volume":"122","author":"Alfieri","year":"2001","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0505","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jacc.2013.12.062","article-title":"Percutaneous mitral valve repair for mitral regurgitation in high-risk patients: results of the EVEREST II study","volume":"64","author":"Glower","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0510","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.jacc.2022.11.034","article-title":"Transcatheter edge-to-edge repair in patients with anatomically complex degenerative mitral regurgitation","volume":"81","author":"Hausleiter","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0515","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.121.010895","article-title":"Recurrent mitral regurgitation after MitraClip: predictive factors, morphology, and clinical implication","volume":"15","author":"Sugiura","year":"2022","journal-title":"Circ Cardiovasc Interv"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0520","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1093\/ehjci\/jez247","article-title":"Mechanisms of mitral regurgitation after percutaneous mitral valve repair with the MitraClip","volume":"21","author":"Ikenaga","year":"2020","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0525","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.jcmg.2016.01.005","article-title":"Predicting LVOT obstruction in transcatheter mitral valve implantation: concept of the neo-LVOT","volume":"10","author":"Blanke","year":"2017","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0530","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.122.027504","article-title":"Percutaneous MitraClip device or surgical mitral valve repair in patients with primary mitral regurgitation who are candidates for surgery: design and rationale of the REPAIR MR trial","volume":"12","author":"McCarthy","year":"2023","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0535","doi-asserted-by":"crossref","first-page":"e80","DOI":"10.1161\/CIRCRESAHA.119.316427","article-title":"A new role for the aldosterone\/mineralocorticoid receptor pathway in the development of mitral valve prolapse","volume":"127","author":"Ibarrola","year":"2020","journal-title":"Circ Res"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0540","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2023.1128195","article-title":"Biology of mitral valve prolapse: from general mechanisms to advanced molecular patterns-a narrative review","volume":"10","author":"Ronco","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.jjcc.2026.09.004_bb0545","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/ehjci\/jeab022","article-title":"Prevalence and extent of mitral annular disjunction in structurally normal hearts: comprehensive 3D analysis using cardiac computed tomography","volume":"22","author":"Toh","year":"2021","journal-title":"Eur Heart J Cardiovasc Imaging"}],"container-title":["Journal of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0914508726001802?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0914508726001802?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T03:12:04Z","timestamp":1791169924000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0914508726001802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":109,"alternative-id":["S0914508726001802"],"URL":"https:\/\/doi.org\/10.1016\/j.jjcc.2026.09.004","relation":{},"ISSN":["0914-5087"],"issn-type":[{"value":"0914-5087","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Mitral valve prolapse: New clinical and scientific insights in 2026","name":"articletitle","label":"Article Title"},{"value":"Journal of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jjcc.2026.09.004","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.","name":"copyright","label":"Copyright"}]}}