Regurgitant fraction ≥50% identified a high-risk subgroup among patients with EROA <40 mm2, who had outcomes comparable to those meeting guideline thresholds for severe MR (p=0.055).
Observational (n=186)
Does regurgitant fraction provide incremental prognostic value over effective regurgitant orifice area and regurgitant volume in patients with ventricular secondary mitral regurgitation?
Regurgitant fraction is a strong prognostic marker in ventricular secondary mitral regurgitation that provides incremental value over EROA and identifies high-risk patients who do not meet standard EROA criteria for severe MR.
p-value: p=<0.05
Objectives: Quantifying ventricular secondary mitral regurgitation (MR) remains challenging, and the prognostic value of echocardiographic parameters is uncertain. This study aimed to assess the concordance of parameters of MR severity and determine the added value of regurgitant fraction (RF) in predicting outcomes. Methods and results: We retrospectively analysed 186 patients with ventricular secondary MR who underwent echocardiography with MR assessment, evaluating effective regurgitant orifice area (EROA), regurgitant volume (RegVol) and RF. The primary endpoint was a composite of all-cause death or heart failure hospitalisation. Quantitative parameters of MR severity were frequently discordant. Using the guideline-recommended cut-offs for EROA (≥40 mm2), RegVol (≥60 mL) and RF (≥50%), severe MR was present in 5.4%, 3.3%, and 29.5% of patients, respectively. Both RF ≥ 50% and EROA ≥ 40 mm2 were independently associated with clinical outcomes in multivariable Cox models. Combining RF and EROA provided incremental prognostic value over either parameter alone (p 50% had outcomes comparable to those who met the guideline-based threshold for severe MR, defined as EROA ≥ 40 mm2. Our results demonstrate that routine RF assessment may enhance risk stratification and enable identification of a high-risk subgroup of patients with EROA < 40 mm2.
Ambrožič et al. (Sun,) conducted a observational in Ventricular secondary mitral regurgitation (n=186). Regurgitant fraction (RF) assessment vs. Effective regurgitant orifice area (EROA) alone was evaluated on Composite of all-cause death or heart failure hospitalisation (p=<0.05). Regurgitant fraction ≥50% identified a high-risk subgroup among patients with EROA <40 mm2, who had outcomes comparable to those meeting guideline thresholds for severe MR (p=0.055).