Why the study?
Aortic stenosis and mitral regurgitation frequently co-occur, complicating diagnosis and treatment, leaving current US treatment trends and patient outcomes unclear.
What is the prognostic impact of concurrent mitral regurgitation in severe aortic stenosis, and does TAVR improve MR severity?
Population
36 402 patients with severe AS and moderate or greater MR across 43 US institutions
Comparison
TAVR alone vs surgery or other transcatheter interventions vs untreated
Design
Multicenter retrospective cohort study
Follow-up
2 years
Key result
In untreated severe aortic stenosis, concurrent moderate-to-severe or severe mitral regurgitation was associated with higher 2-year mortality than less than moderate MR (65.5% vs 36.8%, P<0.001).
Authors
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Concurrent significant MR in untreated severe AS signals high mortality and undertreatment; leaves open whether dual-valve intervention improves outcomes.
Cohort (n=36,402)
Yes
What is the prognostic impact of concurrent mitral regurgitation in severe aortic stenosis, and does TAVR improve MR severity?
Absolute Event Rate: 65.5% vs 36.8%
p-value: p=<0.001
Concurrent significant mitral regurgitation in severe aortic stenosis is associated with high mortality and frequent undertreatment, though TAVR alone improves MR in the majority of treated patients.
Peterson et al. (2026) conducted a cohort in Severe aortic stenosis and at least moderate mitral regurgitation (n=36,402). Moderate-to-severe or severe mitral regurgitation vs. Less than moderate mitral regurgitation was evaluated on 2-year all-cause mortality (p=<0.001). In untreated severe aortic stenosis, concurrent moderate-to-severe or severe mitral regurgitation was associated with higher 2-year mortality than less than moderate MR (65.5% vs 36.8%, P<0.001).