PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
Synapse
⌘+K
Synapse
September 14, 2026Circulation Cardiovascular Interventions

Mitral Regurgitation and Severe Aortic Stenosis: Clinical Characteristics, Prognostic Impact, and Response to TAVR: Insights From Egnite Data

View Full Paper
Ask AI
Bookmark
Share

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

BPBenjamin E. PetersonPGPhilippe GénéreuxPSPinak Shah

Discussion

Loading...

Member takes

Overview

Concurrent significant MR in untreated severe AS signals high mortality and undertreatment; leaves open whether dual-valve intervention improves outcomes.

Key Points

  • To examine treatment patterns, prognostic impact, and valve outcomes among patients presenting with severe aortic stenosis alongside moderate or greater mitral regurgitation.
  • Analyzed records from 2,992,362 patients undergoing 5,245,904 echocardiograms across 43 US institutions in the Egnite Database to identify 36,402 patients with severe aortic stenosis and at least moderate mitral regurgitation.
  • Assessed 2-year all-cause mortality using Kaplan-Meier survival curves and tracked mitral regurgitation severity changes from baseline to 45 days post-procedure in patients receiving transcatheter aortic valve replacement (TAVR) alone.
  • Two-year mortality among untreated patients rose with mitral regurgitation severity: 36.8% (95% CI, 35.6%–38.0%) for less than moderate, 57.3% (95% CI, 54.0%–60.6%) for moderate, and 65.5% (95% CI, 60.9%–70.1%) for moderate-to-severe or severe regurgitation (log-rank P < 0.001).
  • Undertreatment occurred more frequently in patients with severe aortic stenosis and significant mitral regurgitation than in those without significant regurgitation (64.5% vs 49.9%, P < 0.001).
  • Among patients treated with TAVR alone who had follow-up imaging, 77.5% demonstrated meaningful improvement in mitral regurgitation severity within 45 days.

Study Design

Type

Cohort (n=36,402)

Multicenter

Yes

Structured PICO

What is the prognostic impact of concurrent mitral regurgitation in severe aortic stenosis, and does TAVR improve MR severity?

P
Population
36,402 adults (mean age 78.2 years, 45.4% female) with severe aortic stenosis and at least moderate mitral regurgitation, followed for up to 2 years.
E
Exposure
Transcatheter aortic valve replacement (TAVR) alone, surgery, or other transcatheter interventions
C
Comparator
Untreated (conservative management)
O
Outcome
2-year all-cause mortalityhard clinical

Main Result

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.

Cite This Study

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).

synapsesocial.com/papers/6aa7b3580926e14a848b22bchttps://doi.org/10.1161/circinterventions.126.016578
View Full Paper
Ask AI
Bookmark
Share