{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T23:20:18Z","timestamp":1774999218965,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Quadricuspid aortic valve (QAV) is a rare congenital disease. The clinical characteristics of this disease remain unclear except for those in relatively young patients reported from tertiary referral hospitals. The aim of this study was to determine the clinical features of QAV in a regional population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We retrospectively investigated 25\u00a0340 consecutive patients over middle age (median age, 73 (IQR 65\u201380) years; range, 45\u2013102 years) who underwent transthoracic echocardiography (TTE) at our institute during the period from April 2008 to December 2023. Eight (0.032%) of the patients (median age, 65 years; range, 47\u201391 years) were diagnosed with QAV. Six patients suffered from aortic regurgitation (AR), and one patient had mild aortic stenosis at the time of QAV diagnosis. Two patients who had severe AR at referral underwent aortic valve surgery. The severity of AR in the other patients was moderate or less. During a median follow\u2010up period of 27 months (range, 1\u2013171 months), none of the patients other than above two patients had cardiac events. One patient died from a non\u2010cardiac cause at 94 years of age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients diagnosed with QAV after middle age, who do not exhibit severe valve insufficiency at the time of diagnosis, may not experience worse clinical outcomes. However, further research is required for a better understanding of the long\u2010term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15817","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T17:25:50Z","timestamp":1713806750000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical features of quadricuspid aortic valve in middle\u2010aged and elderly patients: Insights from a regional study"],"prefix":"10.1111","volume":"41","author":[{"given":"Azumi","family":"Takiishi","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Kochi Medical School Hospital  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2616-0443","authenticated-orcid":false,"given":"Yuichi","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Ochi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mizuki","family":"Hotta","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Kochi Medical School Hospital  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagisa","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Kochi Medical School Hospital  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuna","family":"Yoshinaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Kochi Medical School Hospital  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Kochi Medical School Hospital  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daigo","family":"Hirakawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juri","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohito","family":"Yamasaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Tokuhiro","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Kochi Medical School Hospital  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Kitaoka","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Geriatrics Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14471"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-192310000-00013"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(73)90332-9"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017743"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)91446-D"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.cr.13-00125"},{"issue":"2","key":"e_1_2_10_8_1","first-page":"134","article-title":"Congenital quadricuspid aortic valve: report of nine surgical cases","volume":"9","author":"Yotsumoto G","year":"2003","journal-title":"Ann Thorac Cardiovasc Surg"},{"issue":"4","key":"e_1_2_10_9_1","first-page":"534","article-title":"The quadricuspid aortic valve: a comprehensive review","volume":"13","author":"Tutarel O","year":"2004","journal-title":"J Heart Valve Dis"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10396-007-0148-9"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.14740\/cr1308"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02913511"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4950251203"},{"issue":"5","key":"e_1_2_10_15_1","first-page":"486","article-title":"Quadricuspid aortic valve without severe dysfunction despite advanced age","volume":"36","author":"Okmen AS","year":"2009","journal-title":"Tex Heart Inst J"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-024-03471-3"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T06:54:42Z","timestamp":1714028082000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.15817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/echo.15817"],"URL":"https:\/\/doi.org\/10.1111\/echo.15817","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2024-03-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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