{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:27Z","timestamp":1787014107492,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T00:00:00Z","timestamp":1582848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mitral valve prolapse (MVP) is often identified in patients with atrial septal defect (ASD), which occasionally require surgical intervention at the time of ASD closure or even long after the surgery. Ventricular and valvular geometric characteristics in preoperative ASD patients were evaluated by three\u2010dimensional (3D) transesophageal echocardiography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      Mitral valve (MV) complex geometry was quantitatively measured by 3D transesophageal echocardiography in 11 ASD patients (Qp\/Qs\u00a0&gt;\u00a01.5) and 11 controls. The ASD group had a significantly larger indexed prolapse volume and height, with a larger anterior mitral leaflet than controls (0.53 [0.33\u20130.75] vs 0.057 [0.027\u20130.11] mL\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.0001; 2.89 [2.13\u20133.50] vs 0.92 [0.48\u20131.32] mm\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001; 391.3 [346.4\u2013445.1] vs 295.3 (281.9\u2013330.0) mm\n                      <jats:sup>2<\/jats:sup>\n                      \/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.011, respectively). The right ventricular (RV)\u2010to\u2010left ventricular (LV) end\u2010systolic diameter ratio was larger in the ASD group than in the control group (1.34 [0.96\u20131.45] vs 0.85 [0.75\u20130.88],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.004). The indexed inter\u2010papillary muscle distance (IPMD) was significantly shorter in the ASD group than in the control group (7.77 [6.55\u20138.24] vs 9.71 [8.64\u201310.8] mm\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.011). IPMD was significantly correlated with the RV\u2010LV end\u2010systolic diameter ratio (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u2212.70,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inward shift of the LV papillary muscle tips due to RV dilation may be a major mechanism of MV prolapse in ASD. At the same time, positive remodeling of the anterior leaflet was observed in the ASD group, which may compensate for the billowing leaflet geometry to maintain effective coaptation. Three\u2010dimensional assessment of the MV apparatus geometry will help to further understand perioperative mitral regurgitation in patients with ASD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.14623","type":"journal-article","created":{"date-parts":[[2020,2,29]],"date-time":"2020-02-29T01:58:56Z","timestamp":1582941536000},"page":"445-452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Unique mechanism of mitral valve prolapse in atrial septal defect: Three\u2010dimensional insights into mitral complex geometry using real\u2010time transesophageal echocardiography"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7623-1057","authenticated-orcid":false,"given":"Makoto","family":"Furugen","sequence":"first","affiliation":[{"name":"Cardiovascular Center Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5879-4382","authenticated-orcid":false,"given":"Shun","family":"Nishino","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Kimura","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichi","family":"Ashikaga","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehiro","family":"Kuriyama","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshisato","family":"Shibata","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Miyazaki Medical Association Hospital Miyazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2008.00726.x"},{"issue":"2","key":"e_1_2_7_3_1","first-page":"237","article-title":"Mitral valve prolapse associated with ostium secundum atrial septal defect\u2013a functional disorder","volume":"59","author":"Suchon E","year":"2004","journal-title":"Acta Cardiol"},{"issue":"5","key":"e_1_2_7_4_1","first-page":"341","article-title":"The role of reduced left ventricular enddiastolic volume in the apparently high prevalence of mitral valve prolapse in atrial septal defect","volume":"11","author":"Angel J","year":"1980","journal-title":"Eur J Cardiol"},{"issue":"11","key":"e_1_2_7_5_1","first-page":"761","article-title":"Mitral valve prolapse and atrial septal defect of the secundum type. 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