{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:20:49Z","timestamp":1791883249599,"version":"4.3.4"},"reference-count":35,"publisher":"American Physiological Society","issue":"3","funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science (JSPS)","doi-asserted-by":"publisher","award":["17K09538"],"award-info":[{"award-number":["17K09538"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American Journal of Physiology-Heart and Circulatory Physiology"],"published-print":{"date-parts":[[2019,3,1]]},"abstract":"<jats:p> Progressive superior shift of the mitral valve (MV) during systole is associated with abnormal papillary muscle (PM) superior shift in late systolic MV prolapse (MVP). The causal relation of these superior shifts remains unclarified. We hypothesized that the MV superior shift is related to augmented MV superiorly pushing force by systolic left ventricular pressure due to MV annular dilatation, which can be corrected by surgical MV plasty, leading to postoperative disappearance of these superior shifts. In 35 controls, 28 patients with holosystolic MVP, and 28 patients with late systolic MVP, the MV coaptation depth from the MV annulus was measured at early and late systole by two-dimensional echocardiography. The PM tip superior shift was monitored by echocardiographic speckle tracking. MV superiorly pushing force was obtained as MV annular area\u2009\u00d7\u2009(systolic blood pressure \u2212 10). Measurements were repeated after MV plasty in 14 patients with late systolic MVP. Compared with controls and patients with holosystolic MVP, MV and PM superior shifts and MV superiorly pushing force were greater in patients with late systolic MVP [1.3 (0.5) vs. 0.9 (0.6) vs. 3.9 (1.0) mm\/m<jats:sup>2<\/jats:sup>, 1.3 (0.5) vs. 1.2 (1.0) vs. 3.3 (1.3) mm\/m<jats:sup>2<\/jats:sup>, and 487 (90) vs. 606 (167) vs. 742 (177) mmHg\u00b7cm<jats:sup>2<\/jats:sup>\u00b7m<jats:sup>\u22122<\/jats:sup>, respectively, means (SD), P &lt; 0.001]. MV superior shift was correlated with PM superior shift ( P &lt; 0.001), which was further related to augmented MV superiorly pushing force ( P &lt; 0.001). MV and PM superior shift disappeared after surgical MV plasty for late systolic MVP. These data suggest that MV annulus dilatation augmenting MV superiorly pushing force may promote secondary superior shift of the MV (equal to late systolic MVP) that causes subvalvular PM traction in patients with late systolic MVP. <\/jats:p><jats:p> NEW &amp; NOTEWORTHY Late systolic mitral valve prolapse (MVP) is associated with mitral valve (MV) and papillary muscle (PM) abnormal superior shifts during systole, but the causal relation remains unclarified. MV and PM superior shifts were correlated with augmented MV superiorly pushing force by annular dilatation and disappeared after surgical MV plasty with annulus size and MV superiorly pushing force reduction. This suggests that MV annulus dilatation may promote secondary superior shifts of the MV (late systolic MVP) that cause subvalvular PM traction. <\/jats:p>","DOI":"10.1152\/ajpheart.00618.2018","type":"journal-article","created":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T09:43:04Z","timestamp":1545385384000},"page":"H629-H638","source":"Crossref","is-referenced-by-count":22,"title":["Possible mechanism of late systolic mitral valve prolapse: systolic superior shift of leaflets secondary to annular dilatation that causes papillary muscle traction"],"prefix":"10.1152","volume":"316","author":[{"given":"Soshi","family":"Hei","sequence":"first","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Iwataki","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong-Yoon","family":"Jang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kuwaki","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitaro","family":"Mahara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Jeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Nabeshima","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Onoue","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasufumi","family":"Nagata","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Nishino","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Miyazaki Medical Association Hospital Cardiovascular Center, Miyazaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Kwan","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Levine","sequence":"additional","affiliation":[{"name":"Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Otsuji","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.07.062"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.30.2.203"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(75)90252-1"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1963.03860010138015"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.109.924332"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.67.3.632"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s12574-018-0370-z"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s12574-018-0394-4"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.005113"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.73.5.1013"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00474-X"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1148\/91.5.898"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.95.3.636"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-18-0333"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-16-1291"},{"key":"B16","first-page":"II159","volume":"94","author":"Komeda M","year":"1996","journal-title":"Circulation"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s12574-013-0165-1"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.09.030"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.05.086"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.118083"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00309.2018"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00339.2017"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.6.1819"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s12574-017-0344-6"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.64.1.113"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.07.029"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-17-1319"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80274-8"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.4.811"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.10.026"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.055111"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00279.2018"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.03.049"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.06.252"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(03)00335-3"}],"container-title":["American Journal of Physiology-Heart and Circulatory Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.physiology.org\/doi\/pdf\/10.1152\/ajpheart.00618.2018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T03:39:30Z","timestamp":1568950770000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.physiology.org\/doi\/10.1152\/ajpheart.00618.2018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,1]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3,1]]}},"alternative-id":["10.1152\/ajpheart.00618.2018"],"URL":"https:\/\/doi.org\/10.1152\/ajpheart.00618.2018","relation":{},"ISSN":["0363-6135","1522-1539"],"issn-type":[{"value":"0363-6135","type":"print"},{"value":"1522-1539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,1]]}}}