{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:55Z","timestamp":1789715035315,"version":"4.0.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with mitral valves prolapse have a heterogeneous course, and long\u2010term outcomes among those &lt;65\u2009years of age are unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients &lt;65\u2009years of age with echocardiographic evidence of MVP at a multihospital academic health system between 2010 and 2024 were evaluated, and all\u2010cause mortality, cardiovascular hospitalization for heart failure, atrial fibrillation, and ventricular arrhythmias (ventricular tachycardia\/ventricular fibrillation\/sudden cardiac arrest) were ascertained using multivariable Cox proportional hazard modeling and competing risk analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The study population comprised 4405 patients with MVP (mean age 49\u00b113\u2009years, 16% &lt;35\u2009years of age, 23% 35\u201350\u2009years of age, 40% men, 92% White) with anterior MVP versus posterior MVP versus bileaflet MVP noted in 34% versus 33% versus 33%, respectively, whereas 16% had moderate or greater mitral regurgitation. Over a median follow\u2010up of 7.8\u00b14\u2009years, 313 patients (7%) died, whereas 11% experienced cardiovascular hospitalization (heart failure: 6.5%, atrial fibrillation: 4%, ventricular tachycardia\/ventricular fibrillation\/sudden cardiac arrest: 1.4%). Defibrillator implantation was performed in 24 (0.5%), whereas 55 (1.2%) patients underwent surgical mitral valve replacement\/repair. Presence of anterior MVP (hazard ratio [HR], 1.7 [95% CI, 1.2\u20132.4];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.003), mitral annular calcification (HR, 2.15 [95% CI, 1.4\u20133.2];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), pulmonary artery systolic pressure (HR, 1.02 [95% CI, 1.02\u20131.03];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), and relative wall thickness (HR, 4.7 [95% CI, 1.2\u201318];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.022) were independent predictors of mortality. Cardiovascular hospitalization was associated significantly with mitral regurgitation severity (HR increase, 1.1\u20136.7) and presence of left atrial enlargement (HR, 1.4 [95% CI, 1.03\u20131.9];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In a large contemporary real\u2010world cohort of patients &lt;65\u2009years of age with MVP, the clinical and echocardiographic profile varies by age at presentation and MVP subtype with appreciable morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046241","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:06:07Z","timestamp":1773831967000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mortality, Hospitalization, and Cardiac Interventions Among Patients With Mitral Valve Prolapse &lt;65\u2009Years of Age"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-5977","authenticated-orcid":false,"given":"Aditya","family":"Bhonsale","sequence":"first","affiliation":[{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]},{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Zawadzki","sequence":"additional","affiliation":[{"name":"University of Pittsburgh","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floyd","family":"Thoma","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2490-8833","authenticated-orcid":false,"given":"William","family":"Katz","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1577-6541","authenticated-orcid":false,"given":"Andrew","family":"Voigt","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]},{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-7678","authenticated-orcid":false,"given":"Alaa","family":"Shalaby","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]},{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5461-7247","authenticated-orcid":false,"given":"N. A.","family":"Estes","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]},{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2550-9359","authenticated-orcid":false,"given":"Krishna","family":"Kancharla","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]},{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4669-803X","authenticated-orcid":false,"given":"Samir","family":"Saba","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, USA"]},{"name":"University of Pittsburgh Medical Center","place":["Pittsburgh, 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