Key result
Optimized medical therapy anchors moderate functional MR care, with TEER reserved for persistent symptoms.
Why the study?
Randomized clinical trials have primarily focused on severe FMR, leaving the prognostic implications and management of moderate FMR as an area requiring review.
What is the optimal approach to the diagnosis and management of moderate functional mitral regurgitation in patients with heart failure?
What is the optimal approach to the diagnosis and management of moderate functional mitral regurgitation in patients with heart failure?
This review highlights the growing recognition of moderate functional mitral regurgitation, outlining a personalized therapeutic algorithm that prioritizes guideline-directed medical therapy followed by targeted transcatheter interventions.
Supports prioritizing medical therapy in moderate functional MR; leaves open incremental benefit of edge-to-edge repair pending prospective trials.
Functional mitral regurgitation (FMR) is common in patients with heart failure (HF) and is associated with an adverse prognosis. Therefore, both ventricular and atrial phenotypes of FMR represent relevant therapeutic targets in clinical practice. Although randomized clinical trials have primarily focused on the treatment of severe FMR, the prognostic implications and management of moderate FMR have emerged as a topic of increasing interest. This review aims to provide an overview of epidemiology, prognosis, and management of moderate FMR, with a focus on the role of pharmacological treatments and emerging percutaneous strategies.
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Coletti et al. (2026) conducted a review in Moderate functional mitral regurgitation in heart failure. Optimized medical therapy and transcatheter edge-to-edge mitral valve repair (M-TEER) was evaluated. Optimized medical therapy remains the first-line treatment for moderate functional mitral regurgitation, with transcatheter edge-to-edge repair offering potential benefits for persistently symptomatic patients.
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