AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2641-0419/506
*Corresponding Author: L. Baciulescu, Cardiologie, Centre Hospitalier Agen-Nérac (site d’Agen), Agen, France.
Citation: L. Baciulescu, (2025), Mitral valve prolapse and long QT interval: the missing link explaining sudden cardiac death in these patients?, J Clinical Cardiology and Cardiovascular Interventions, 8(15); DOI:10.31579/2641-0419/506
Copyright: © 2025, L. Baciulescu. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 07 August 2025 | Accepted: 03 November 2025 | Published: 12 November 2025
Keywords: mitral valve prolapse (MVP); ventricular tachycardia (VT); ventricular fibrillation (VF)
Introduction: Mitral valve prolapse (MVP) is associated with ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD). It is considered that SCD requires a substrate, a trigger, and a modifying risk factor, but not all patients with MP-related SCD/VT/FV have a substrate (fibrosis or severe mitral regurgitation -MR or mitral annular disjunction -MAD).
Objective: This case presentation suggests that the missing link explaining SCD in some patients with MVP is a significant variability of the QTc interval with a pathological prolonged QT interval preceding MP-related SCD/VT/FV. Subclinical inflammation could be the substrate.
Method: I present to you the case of a patient aged 72 with MVP, severe MR and a NSTEMI (sub occlusion of the distal right coronary) who was implanted with a subcutaneous defibrillator (S-ICD) after an aborted sudden cardiac arrest, followed by repeated arrhythmic events (AE) in the next weeks, despite revascularisation. The ECG performed in the intensive care unit showed a prolonged QTI of 531ms. A cardiac MRI was performed, finding a preserved left ventricular ejection fraction (LVEF) with infero-septal hypoperfusion without evidence of necrosis or inflammation. Because of the multiples complications during and after the initial hospitalization, a Mitra Clip procedure was performed at distance. The echocardiography post intervention showed a mild residual MR and normal LVEF. After the intervention, the betablockers were stopped because of a tendency to mild bradycardia but two weeks later, the patient was re hospitalised for traumatic syncope. The first ECG found a long QTI (500ms) but the followings showed an important QTc interval variability, with sometimes normal values and frequent ectopy. The patient’s blood tests were completely normal. The consultation of the S-ICD showed a good functioning and one VF preceded by prolonged QTI. During the hospitalisation, the patient presented another syncope due to a new FV (figure 1) despite the absence of any acute trigger. There is a long QTI (not standardized measurement on S-ICD tracings but QTI longer than half of the RR space) preceding the VF. The diagnosis of an associated congenital long QT syndrome (LQTS) was ruled out. After the resumption of beta-blockers, the patient no longer presented with sustained arrhythmias.
Results: This patient with MVP presented multiple AE (VF), each one preceded by a prolonged QT interval, in the absence of congenital LQTS, probably related to subclinical inflammation.
Conclusion: Is there a significant QTc interval variability, with the appearance of a long QTI preceding malignant arrhythmias in all patients with MVP? Should we treat MVP like LQTS and avoid any drug or situation that could prolong the QTI?
Mitral valve prolapse (MVP) is a common valvular heart disease with 2-3% prevalence. Arrhythmogenic bileaflet MVP (ABiMVPS) syndrome was described with female predominance. The annual rate of sudden cardiac death in MVP is double the general population at 0.2-0.4%/year. The coexistence of ABiMVPS and congenital long QT syndrome (LQTS) is rare but malignant.
Mitral valve prolapse is associated with ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD). The risk of SCD is specific for the MVP substrate and independent of mitral regurgitation (MR) severity (80% of SCD occur in patients with moderate mitral regurgitation).
High risk features include complex ventricular ectopy (couplets, triplets, pleiomorphic VC), T wave inversion in the inferior leads, mitral annular disjunction – MAD (detachment of the ‘roots’ of the annulus from the ventricular myocardium causing myocardial stretch), myocardial fibrosis seen at cardiac MRI (papillary muscle/ infero basal LV), high lateral annular velocities with spiked configuration due to mechanical traction -the Pickelhaube sign ( peak systolic lateral velocity of the lateral mitral annulus >1.6 m/s), low ejection fraction, impaired global longitudinal strain, greater mechanical dispersion, double peak strain, which can all be identified with common imaging modalities.
Bi-leaflet prolapse, ≥ moderate mitral regurgitation and female gender are also associated with greater risk of SCD.
Furthermore, there is evidence of increased sympathetic activity, coupled with decreased vagal activity and elevated catecholamine levels in MVP patients with a high ventricular arrhythmic load. This autonomic dysfunction not only increases the frequency of ectopic activity but also predisposes the ventricular myocardium to ectopic activity.
Severe mitral regurgitation may be responsible for the high mechanical traction and stretch that can induce complex ventricular ectopy due to triggered activity even in the absence of intramyocardial fibrosis.
MAD is not always present in patients who have MVP and it can be found in patients without MVP. In a Norwegian study which enrolled 116 patients with MAD, 34% of them presented with severe VT. This study supported that papillary muscle fibrosis may be linked to severe arrhythmic events and showed an association among PVCs, arrhythmic events and MAD independently of the presence of MVP, indicating that MAD itself may be an arrhythmogenic entity. However, more studies are needed to prove and better define this.
The mechanism of SCD in MVP is not completely elucidated. It is considered that SCD requires a substrate, a trigger, and a modifying risk factor, but not all patients with MVP-related SCD/VT/FV have fibrosis or severe mitral regurgitation. Subclinical inflammation and a prolonged QT interval may be the missing link in these patients.
The objective of this case presentation is to demonstrate that there is a significant variability of the QTc interval and that a pathological prolonged QT interval precedes multiples episodes of VT/VF and SCD in a female patient with idiopathic bi leaflet MVP.
I present to you the case of a patient aged 72 with mitral bi-leaflet prolapse, severe mitral regurgitation and a non-ST elevation myocardial infarction (sub occlusion of the distal right coronary artery) who was hospitalised in the intensive care unit after an aborted sudden cardiac arrest, followed by repeated and frequent arrhythmic events (VT and VF in the next weeks, necessitating multiples external electrical shocks, despite revascularisation).
The patient’s medical history: substituted central hypothyroidism, breast surgery for lobular carcinoma in situ, sudden death of her father at the age of 64 (myocardial infarction).
The ECG done in the intensive care unit shows a prolonged QT interval of 531ms (figure 1). Beta blockers and magnesium were administrated with shortening of the QT interval, which remains pathological during the hospitalisation in the ICU (figure 2).
Figure 1
Figure 2
A cardiac MRI was performed, finding a preserved left ventricular ejection fraction with infero-septal hypoperfusion without evidence of necrosis in the viability sequences; high-grade mitral regurgitation is confirmed; no abnormality suggestive of myocarditis were found.
The patient had multiple complications during and after the hospitalization in the intensive care unit (ICU): sepsis due to lung infection, pulmonary embolism and atrial fibrillation, so the heart team decided that a MITRA CLIP procedure was the best option (because of the high operative risk of the mitral valvuloplasty). The patient was implanted with a subcutaneous defibrillator (S-ICD) and the Mitra Clip intervention was performed 7 months later.
The echocardiography post intervention showed a good result: mild residual mitral regurgitation after the positioning of two mitral clips, normal ejection fraction.
After this intervention, the betablockers were stopped because of a tendency to mild bradycardia. Two to three weeks after the MITRA CLIP intervention, the patient was hospitalised for syncope with cranial trauma.
The initial ECG found a sinus rhythm, first-degree AV block with left atrial hypertrophy (PR 230ms), an anterior left hemiblock, a long QT (500ms), premature ventricular complexes (PVC) as shown in figure 3:
Figure: 3
The interrogation of the S-ICD found one arrhythmic event (appropriate electrical shock for VF) preceded by prolonged QT interval (figure 4)
Figure: 5
The patient’s blood tests were completely normal, especially troponins, brain natriuretic peptide, potassium, calcium, and magnesium, TSH.
The ECGs showed an important QTc interval variability, with sometimes values considered normal for women (453ms) and frequent premature polymorphic ventricular complexes (figure 5).
Figure: 5
During the hospitalisation, the patient presented another syncope due to a new arrhythmic event despite the absence of any acute trigger (no infection, no ischemia, no electrolyte abnormalities or hormonal imbalance, no QT-prolonging drugs etc) except probably the subclinical inflammation due to the recent Mitra clip intervention (figure 6).
There is an elongated QT interval (not standardized measurement on S-ICD tracings but QT interval longer than half of the RR space) and we can see a PVC that falls on a T wave resulting in ventricular fibrillation. An appropriate choc was delivered by the S-ICD.
The betablockers were reintroduced slowly followed by complete stabilisation of the patient.
The diagnosis of an associated congenital long QT syndrome was ruled out by the heart team after preceding to specific tests, but genetic testing was not done.
After the resumption of beta-blockers, the patient no longer presented with sustained arrhythmias (a 7-year period of follow-up), despite the recurrence of severe mitral regurgitation requiring surgical revision a few years after Mitra Clip intervention.
A double chamber transvenous defibrillator was implanted because of sinus node dysfunction.
This patient presented multiple arrhythmic events (VF), each one preceded by a prolonged QT interval. The initial aborted SCD was due to the acute coronary syndrome and MVP with severe mitral regurgitation, the fallowing two arrhythmic events occurred shortly after a Mitra Clip intervention, in the context of betablocker interruption and no other potential trigger found, except the variability of the QTI, with prolonged QT interval before VF.
Risk stratification of MVP is not clear despite the plethora of risk factors associated with it because there is still no strong predictor of malignant arrhythmias. Additionally, it is not clear which combination of risk factors incurs the highest risk.
The diagnosis of long QT syndrome (LQTS) is primarily based on the measurement of the QTc interval (corrected QT), which is usually elongated, although 20% to 25% of patients with mutation confirmed LQTS may have normal QTc; the overlap in resting QTc intervals between healthy people and patients with LQTS makes diagnosis difficult.
The association between LQTS and mitral prolapse is classical but understudied and not fully understood; these patients frequently have negative and asymmetrical T waves in the inferior leads and a QT interval slightly longer than normal, but they are not genotyped because it is considered that these modifications are caused by the mechanical traction/stretch of the pillars.
These also means that any further enlargement of the QT interval in patients with mitral valve prolapse (caused by ischemia, inflammation, fibrosis, QT-prolonging drugs, hypokalaemia, hypocalcaemia, hypomagnesemia etc) can increase the risk of arrhythmic event and sudden cardiac death much more then in patients without mitral valve prolapse.
An unknown proportion of patients have a congenital LQTS associated to mitral valve prolapse and their risk of SCD is even greater.
The congenital LQTS type 3 is more difficult to diagnose, and it differs from LQTS1 and 2 in various aspects. LQTS3 patients present more often with marked resting bradycardia and QT prolongation is more pronounced during slow heart rate (rest, sleep) with in fact normalisation at faster heart rates. The first cardiac event is more likely to be fatal. Of the known genetic variants of the long QT syndrome, the long QT3 variant results from mutations in the SCN5A gene and accounts for 5% to 10% of clinical cases.
Sudden cardiac death was described due to a novel disease causing mutation in the SCN5A gene encoding the cardiac sodium channel in a patient with myxomatous mitral valve disease and flail posterior leaflet treated with the macrolide antibiotic azithromycin.
Prolongation of the QTc interval in patients with MVP has been reported in several studies. The incidence in these studies has been variable, ranging from 91 to 26%. Not all investigations, however, have found a correlation between MVP and prolonged QTc intervals. The Framingham study revealed no evidence of QT prolongation in association with MVP. The incidence of QTc prolongation has clinical significance because several investigators have implied a relation between this repolarization abnormality and sudden death in patients with MVP.
This case suggests that there is a significant variability in the QTc interval in patients with idiopathic mitral valve prolapse (no congenital LQTS) with the appearance of a long QT interval preceding malignant arrhythmias and SCD.
The discovery of a long QT interval in a patient with MVP and bradycardia (but normal QTI when the heart rate is high) could suggest the coexistence of a congenital LQTS3. Studies are necessary to see if beta-blockers could unmask this syndrome.
There is increasing evidence of a genetic association between MVP and LQTS, atrial fibrillation, sinus node dysfunction and cardiomyopathy (dilated cardiomyopathy, noncompaction).
“SCN5A gene encodes the pore-forming ion-conducting α-subunit of the cardiac sodium channel (Nav1.5), which is responsible for the initiation and propagation of action potentials and thereby determines cardiac excitability and conduction of electrical stimuli through the heart. The importance of Nav1.5 for normal cardiac electricity is reflected by various disease entities that can be caused by mutations in SCN5A. Gain-of-function mutations in SCN5A lead to more sodium influx into cardiomyocytes through aberrant channel gating and cause long QT syndrome, a primary electrical disease of the heart. Loss-of-function mutations in SCN5A lead to lower expression levels of SCN5A or production of defective Nav1.5 proteins and cause Brugada syndrome, an electrical disease with minor structural changes in the heart. In addition, both loss- and gain-of-function mutations may cause dilated cardiomyopathy, which is an arrhythmogenic disease with gross structural defects of the left ventricle (and sometimes both ventricles). Other SCN5A-related diseases are multifocal ectopic premature Purkinje-related complexes (gain-of-function mutations), isolated cardiac conduction defect (loss-of-function mutations), sick sinus syndrome (loss-of-function mutations), atrial fibrillation (loss-of-function or gain-of-function mutations), and overlap syndromes (mutations with both loss-of-function and gain-of-function effects). Growing insights into the role of SCN5A in health and disease has enabled clinicians to lay out gene-specific risk stratification schemes and mutation-specific diagnostic and therapeutic strategies in the management of patients with a SCN5A mutation” (A).
Longitudinal studies are necessary to determine if the prolongation of the QT interval just before malignant arrythmia is the underlying mechanism of SCD in MVP.
The possibles implications of confirming this mechanism are significant. Should we treat MVP like a congenital LQTS?
Beta-blockers and lifestyle modifications such as avoiding stimulants such as caffeine, tobacco, alcohol and recreational drugs are already recommended in MVP.
An ICD is indicated for the secondary prevention of out-of-hospital cardiac arrest. Implantation of a loop recorder may be considered dependent on the number of high-risk features present. In the case of suspected arrhythmic syncope and evidence of scarring, it is acceptable to consider an electrophysiology study. Catheter ablation of scar-related malignant arrhythmias has been reported as an effective treatment, but recurrence rate is high.
Prevention and correction of electrolyte abnormalities (hypokalaemia, hypocalcaemia, hypomagnesemia) that can occur during long hospitalisations or in cases of diarrhoea, vomiting, metabolic disorders and unbalanced diets is necessary in all cases.
Aggressive prevention of ischemic heart disease is paramount.
The fallowing questions are to be answered.
Should we genotype all MVP patients? Or only those with high-risk features for SCD ?
As a preventive measure for SCD associated with MVP, should these patients be treated with high dose, non-selective beta-blockers? Should we ban QT-prolonging drugs like amiodarone, sotalol, flecainide, macrolides etc or competitive sport? Should an ICD be implanted if a significant variability of the QT interval is found in MVP patients? Or in case of a sinus node dysfunction necessitating pacing?
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
