Key result
Severe functional mitral regurgitation is linked to ~76% higher mortality in HFrEF patients.
Why the study?
Despite efforts to reduce functional mitral regurgitation to improve chronic heart failure prognosis, its prognostic impact under optimal medical therapy and the specific phenotype where it drives disease remained unclear.
Population
576 consecutive HFrEF patients
Comparison
Severe FMR vs non-severe FMR across HFrEF phenotypes
Design
Prospective long-term observational study
Follow-up
Median 62 months
Authors
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Perhaps the most important finding in this context is that mitral regurgitation primarily influences the survival of those patients whose heart failure is not yet very advanced. This indicates that there is a particular 'window of opportunity' that should be used to make an appropriate intervention.”
Severe FMR signals higher mortality risk in HFrEF; leaves open whether targeted intervention improves outcomes.
Observational (n=576)
Effect estimate: HR 1.76 (95% CI 1.34-2.30)
p-value: p=<0.001
Goliasch et al. (2017) conducted an observational in Heart failure with reduced ejection fraction (HFrEF) (n=576). Severe functional mitral regurgitation (FMR) was evaluated on Mortality (HR 1.76, 95% CI 1.34-2.30, p=<0.001). Severe functional mitral regurgitation was a significant independent predictor of mortality in HFrEF patients (HR 1.76; 95% CI 1.34-2.30; P<0.001), particularly in an intermediate-failure phenotype.
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