{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:20:02Z","timestamp":1791390002846,"version":"4.3.3"},"reference-count":27,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["NIH K23HL116652"],"award-info":[{"award-number":["NIH K23HL116652"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2016,7,19]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      We aimed to investigate the association of diffuse myocardial fibrosis by cardiac magnetic resonance (CMR) T\n                      <jats:sub>1<\/jats:sub>\n                      with complex ventricular arrhythmia (ComVA) in mitral valve prolapse (MVP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was performed on 41 consecutive patients with MVP referred for CMR between 2006 and 2011, and 31 healthy controls. Arrhythmia analysis was available in 23 patients with MVP with Holter\/event monitors. Left ventricular (LV) septal T\n                      <jats:sub>1<\/jats:sub>\n                      times were derived from Look-Locker sequences after administration of 0.2\u2005mmol\/kg gadopentetate dimeglumine. Late gadolinium enhancement (LGE) CMR images were available for all subjects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with MVP had significantly shorter postcontrast T\n                      <jats:sub>1<\/jats:sub>\n                      times when compared with controls (334\u00b152 vs 363\u00b158\u2005ms; p=0.03) despite similar LV ejection fraction (LVEF) (63\u00b17 vs 60\u00b16%, p=0.10). In a multivariable analysis, LV end-diastolic volume, LVEF and mitral regurgitation fraction were all correlates of T\n                      <jats:sub>1<\/jats:sub>\n                      times, with LVEF and LV end-diastolic volume being the strongest (p=0.005, p=0.008 and p=0.045, respectively; model adjusted R\n                      <jats:sup>2<\/jats:sup>\n                      =0.30). Patients with MVP with ComVA had significantly shorter postcontrast T\n                      <jats:sub>1<\/jats:sub>\n                      times when compared with patients with MVP without ComVA (324 (296, 348) vs 354 (327, 376) ms; p=0.03) and only 5\/14 (36%) had evidence of papillary muscle LGE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      MVP may be associated with diffuse LV myocardial fibrosis as suggested by reduced postcontrast T\n                      <jats:sub>1<\/jats:sub>\n                      times. Diffuse interstitial derangement is linked to subclinical systolic dysfunction, and may contribute to ComVA in MVP-related mitral regurgitation, even in the absence of focal fibrosis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/heartjnl-2016-309303","type":"journal-article","created":{"date-parts":[[2016,8,11]],"date-time":"2016-08-11T22:58:33Z","timestamp":1470956313000},"page":"204-209","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":140,"title":["Diffuse myocardial fibrosis in patients with mitral valve prolapse and ventricular arrhythmia"],"prefix":"10.1136","volume":"103","author":[{"given":"An H","family":"Bui","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Roujol","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murilo","family":"Foppa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Cardiology, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kraig V","family":"Kissinger","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Goddu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas H","family":"Hauser","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Zimetbaum","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long H","family":"Ngo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren J","family":"Manning","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Nezafat","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca N","family":"Delling","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Department of Medicine, Division of Cardiology, University of California, San Francisco, California, 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