{"id":"https://openalex.org/W71707066","doi":"https://doi.org/10.1161/circ.124.suppl_21.a17938","title":"Abstract 17938: Evidence of Vicious Cycle in Mitral Regurgitation with Prolapse: Secondary Tethering Due to Primary Prolapse Demonstrated by 3-Dimensional Echocardiography Exacerbates Regurgitation","display_name":"Abstract 17938: Evidence of Vicious Cycle in Mitral Regurgitation with Prolapse: Secondary Tethering Due to Primary Prolapse Demonstrated by 3-Dimensional Echocardiography Exacerbates Regurgitation","publication_year":2011,"publication_date":"2011-11-22","ids":{"openalex":"https://openalex.org/W71707066","doi":"https://doi.org/10.1161/circ.124.suppl_21.a17938","mag":"71707066"},"language":"en","primary_location":{"id":"doi:10.1161/circ.124.suppl_21.a17938","doi":"https://doi.org/10.1161/circ.124.suppl_21.a17938","is_oa":false,"landing_page_url":"http://dx.doi.org/10.1161/circ.124.suppl_21.a17938","pdf_url":null,"source":{"id":"https://openalex.org/S116251202","display_name":"Circulation","issn_l":"0009-7322","issn":["0009-7322","1524-4539"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Circulation","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5087377791","display_name":"Kyoko Otani","orcid":"https://orcid.org/0000-0003-2293-9791","observed_orcids":["https://orcid.org/0000-0003-2293-9791"]},"institutions":[{"id":"https://openalex.org/I188700360","display_name":"University of Occupational and Environmental Health Japan","ror":"https://ror.org/020p3h829","country_code":"JP","type":"education","lineage":["https://openalex.org/I188700360"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Kyoko Otani","raw_affiliation_strings":["2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","Kyoko Otani"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","institution_ids":["https://openalex.org/I188700360"]},{"raw_affiliation_string":"Kyoko Otani","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5013432648","display_name":"Masaaki Takeuchi","orcid":"https://orcid.org/0000-0001-7606-1537","observed_orcids":["https://orcid.org/0000-0001-7606-1537"]},"institutions":[{"id":"https://openalex.org/I188700360","display_name":"University of Occupational and Environmental Health Japan","ror":"https://ror.org/020p3h829","country_code":"JP","type":"education","lineage":["https://openalex.org/I188700360"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Masaaki Takeuchi","raw_affiliation_strings":["2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","Masaaki Takeuchi"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","institution_ids":["https://openalex.org/I188700360"]},{"raw_affiliation_string":"Masaaki Takeuchi","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5009182157","display_name":"Kyoko Kaku","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I188700360","display_name":"University of Occupational and Environmental Health Japan","ror":"https://ror.org/020p3h829","country_code":"JP","type":"education","lineage":["https://openalex.org/I188700360"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Kyoko Kaku","raw_affiliation_strings":["2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","Kyoko Kaku"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","institution_ids":["https://openalex.org/I188700360"]},{"raw_affiliation_string":"Kyoko Kaku","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031368351","display_name":"Nobuhiko Haruki","orcid":"https://orcid.org/0000-0002-0369-0356","observed_orcids":["https://orcid.org/0000-0002-0369-0356"]},"institutions":[{"id":"https://openalex.org/I188700360","display_name":"University of Occupational and Environmental Health Japan","ror":"https://ror.org/020p3h829","country_code":"JP","type":"education","lineage":["https://openalex.org/I188700360"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Nobuhiko Haruki","raw_affiliation_strings":["2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","Nobuhiko Haruki"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","institution_ids":["https://openalex.org/I188700360"]},{"raw_affiliation_string":"Nobuhiko Haruki","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110340007","display_name":"Hidetoshi Yoshitani","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I188700360","display_name":"University of Occupational and Environmental Health Japan","ror":"https://ror.org/020p3h829","country_code":"JP","type":"education","lineage":["https://openalex.org/I188700360"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Hidetoshi Yoshitani","raw_affiliation_strings":["2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","Hidetoshi Yoshitani"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","institution_ids":["https://openalex.org/I188700360"]},{"raw_affiliation_string":"Hidetoshi Yoshitani","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5003717488","display_name":"Robert A. Levine","orcid":"https://orcid.org/0000-0002-9484-8218","observed_orcids":["https://orcid.org/0000-0002-9484-8218"]},"institutions":[{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Robert A Levine","raw_affiliation_strings":["Cardiac Ultrasound Laboratory, Massachusetts General Hosp, Boston, MA","Robert A Levine"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Cardiac Ultrasound Laboratory, Massachusetts General Hosp, Boston, MA","institution_ids":["https://openalex.org/I4210087915"]},{"raw_affiliation_string":"Robert A Levine","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5070917258","display_name":"Yutaka Otsuji","orcid":"https://orcid.org/0000-0003-2388-0103","observed_orcids":["https://orcid.org/0000-0003-2388-0103"]},"institutions":[{"id":"https://openalex.org/I188700360","display_name":"University of Occupational and Environmental Health Japan","ror":"https://ror.org/020p3h829","country_code":"JP","type":"education","lineage":["https://openalex.org/I188700360"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yutaka Otsuji","raw_affiliation_strings":["2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","Yutaka Otsuji"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"2nd department of internal medicine, Univ of Occupational and Environmental Health, Kitakyushu, Japan","institution_ids":["https://openalex.org/I188700360"]},{"raw_affiliation_string":"Yutaka Otsuji","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"124","issue":"suppl_21","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10172","display_name":"Cardiac Valve Diseases and Treatments","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10172","display_name":"Cardiac Valve Diseases and Treatments","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12598","display_name":"Cardiac Structural Anomalies and Repair","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10882","display_name":"Cardiomyopathy and Myosin Studies","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/mitral-valve-prolapse","display_name":"mitral valve prolapse","score":0.9210000038146973},{"id":"https://openalex.org/keywords/mitral-regurgitation","display_name":"mitral regurgitation","score":0.996999979019165},{"id":"https://openalex.org/keywords/mitral-leaflet-tethering","display_name":"mitral leaflet tethering","score":0.8529999852180481},{"id":"https://openalex.org/keywords/left-ventricular-dilation","display_name":"left ventricular dilatation","score":0.8429999947547913},{"id":"https://openalex.org/keywords/posterior-leaflet-prolapse","display_name":"posterior leaflet prolapse","score":0.6990000009536743},{"id":"https://openalex.org/keywords/vicious-circle","display_name":"vicious circle","score":0.7540000081062317},{"id":"https://openalex.org/keywords/three-dimensional-echocardiography","display_name":"three-dimensional echocardiography","score":0.7789999842643738},{"id":"https://openalex.org/keywords/transesophageal-echocardiography","display_name":"transesophageal echocardiography","score":0.8330000042915344},{"id":"https://openalex.org/keywords/regurgitation-volume","display_name":"regurgitation volume","score":0.703000009059906}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9567425847053528},{"id":"https://openalex.org/C2993373945","wikidata":"https://www.wikidata.org/wiki/Q268292","display_name":"Mitral regurgitation","level":2,"score":0.8298119902610779},{"id":"https://openalex.org/C201815810","wikidata":"https://www.wikidata.org/wiki/Q833066","display_name":"Tethering","level":2,"score":0.6807648539543152},{"id":"https://openalex.org/C2781030672","wikidata":"https://www.wikidata.org/wiki/Q735652","display_name":"Mitral valve prolapse","level":3,"score":0.6536560654640198},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.586691677570343},{"id":"https://openalex.org/C2780168065","wikidata":"https://www.wikidata.org/wiki/Q1930043","display_name":"Regurgitation (circulation)","level":2,"score":0.5836552977561951},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5459389686584473},{"id":"https://openalex.org/C2777543888","wikidata":"https://www.wikidata.org/wiki/Q369939","display_name":"Mitral valve","level":2,"score":0.24457913637161255},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.0},{"id":"https://openalex.org/C111919701","wikidata":"https://www.wikidata.org/wiki/Q9135","display_name":"Operating system","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1161/circ.124.suppl_21.a17938","doi":"https://doi.org/10.1161/circ.124.suppl_21.a17938","is_oa":false,"landing_page_url":"http://dx.doi.org/10.1161/circ.124.suppl_21.a17938","pdf_url":null,"source":{"id":"https://openalex.org/S116251202","display_name":"Circulation","issn_l":"0009-7322","issn":["0009-7322","1524-4539"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Circulation","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9537000060081482,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2022573371","https://openalex.org/W4385295035","https://openalex.org/W3187158020","https://openalex.org/W2042784376","https://openalex.org/W2028094285","https://openalex.org/W4225609782","https://openalex.org/W2262385914","https://openalex.org/W1997393588","https://openalex.org/W3158789123","https://openalex.org/W2060203010"],"abstract_inverted_index":{"Background:":[0],"In":[1,108],"patients":[2,62,79,178],"with":[3,44,63,80,179,198,217,242],"mitral":[4,31,246],"valve":[5,251],"prolapse":[6,46,67,121,181,207,227],"(MVP),":[7],"we":[8],"often":[9],"observe":[10],"that":[11,22,40,236],"non-prolapsed":[12],"leaflets":[13,113,131,214],"are":[14],"tented":[15],"(apically":[16],"displaced)":[17],"(Figure).":[18],"We":[19],"hypothesized":[20],"1)":[21,169],"secondary":[23,41,245],"left":[24],"ventricular":[25],"(LV)":[26],"dilatation":[27,238],"due":[28],"to":[29,51,119,183],"primary":[30,45,240],"regurgitation":[32],"(MR)":[33],"causes":[34,244],"this":[35],"leaflet":[36,65,71,247],"tethering":[37,42],"and":[38,49,68,75,114,122,140,208,223,228,253],"2)":[39,190],"along":[43],"exacerbates":[47],"malcoaptation":[48],"contributes":[50],"the":[52,100,129,135,141,212],"severity":[53],"of":[54,99,128,137,206,211],"MR.":[55],"Methods:":[56],"3DTEE":[57],"was":[58,117,132,149,154,174,195],"performed":[59],"in":[60,144,177],"20":[61,78],"posterior":[64],"(PML)":[66],"intact":[69],"anterior":[70],"(AML)":[72],"by":[73,164,239],"TEE":[74],"surgical":[76],"observation.":[77],"cerebral":[81],"infarction":[82],"but":[83],"without":[84],"cardiac":[85],"disease":[86],"served":[87],"as":[88,134,156],"controls.":[89],"From":[90],"mid-systolic":[91,199],"3D":[92],"zoom":[93],"datasets,":[94],"10":[95],"parallel":[96],"antero-posterior":[97],"planes":[98],"MV":[101],"were":[102],"obtained":[103,133],"using":[104],"i-slice":[105],"mode":[106],"(Q-LAB).":[107],"each":[109,145],"view,":[110],"area":[111,143],"between":[112],"annular":[115],"line":[116],"measured":[118],"obtain":[120],"tenting":[123,172,193,209,229],"area,":[124],"respectively.":[125],"Prolapse/tenting":[126],"volume":[127,148,153,159,163,173,194,201,210,219],"whole":[130,213],"product":[136],"inter-slice":[138],"distance":[139],"prolapse/tenting":[142],"plane.":[146],"LV":[147,157,200,237],"also":[150],"measured.":[151],"MR":[152,218,243],"calculated":[155],"ejection":[158],"minus":[160],"aortic":[161],"stroke":[162],"pulsed":[165],"Doppler":[166],"method.":[167],"Results:":[168],"The":[170,191,233],"AML":[171,192],"significantly":[175,196],"larger":[176],"PML":[180],"compared":[182],"controls":[184],"(1.04\u00b10.54":[185],"vs":[186],"0.58\u00b10.14":[187],"ml/m2,":[188],"p<0.001).":[189,203],"correlated":[197,216],"(r=0.61,":[202],"3)":[204],"Sum":[205],"strongly":[215],"(r=0.66,":[220],"p<0.01)":[221],"(r=0.38":[222],"0.48":[224],"for":[225],"isolated":[226],"volume,":[230],"respectively).":[231],"Conclusion:":[232],"results":[234],"suggest":[235],"MVP":[241],"tethering,":[248],"which":[249],"worsens":[250],"leakage":[252],"constitutes":[254],"a":[255],"vicious":[256],"cycle.":[257]},"counts_by_year":[],"updated_date":"2026-10-14T16:39:01.820549","created_date":"2016-06-24T00:00:00"}
