Why the study?
Functional mitral regurgitation in the setting of left ventricular dysfunction and heart failure carries a poor prognosis, while surgical correction remains controversial and new transcatheter therapies are emerging.
This review summarizes the pathophysiology, prognosis, and evolving treatment options, including transcatheter therapies, for functional mitral regurgitation in heart failure.
Provides clinicians an updated synthesis on functional MR in HF; leaves open optimal transcatheter strategies pending randomized trials.
Functional mitral regurgitation (FMR) in the setting of left ventricular (LV) dysfunction and heart failure portends a poor prognosis. Guideline-directed medical therapy remains the cornerstone of initial treatment, with emphasis placed on treatment of the underlying LV dysfunction, as FMR is a secondary phenomenon and a disease due to LV remodeling. Surgical correction of FMR is controversial because it typically does not address the underlying mechanism and etiology of the condition. However, new, minimally invasive transcatheter therapies, in particular the MitraClip system, have shown promise in the treatment of FMR in selected patients. This review will summarize the pathophysiology underlying FMR, the prognosis of patients with heart failure and FMR, and the various medical and procedural treatment options currently available and under investigation.
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Shah et al. (2019) studied this question.
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