Key result
The number of additional morphological factors present was independently associated with disproportionate functional mitral regurgitation (OR 4.15).
Why the study?
Does mitral valve morphology determine disproportionality in functional mitral regurgitation in patients undergoing transcatheter edge-to-edge repair?
Observational (n=114)
No
Does mitral valve morphology determine disproportionality in functional mitral regurgitation in patients undergoing transcatheter edge-to-edge repair?
Additional morphological factors such as pseudo-prolapse, extreme annular dilatation, and deep indentation contribute to disproportionate functional mitral regurgitation beyond left ventricular size alone.
May support morphology-informed FMR phenotyping; leaves open effects on TEER outcomes and need for prospective validation.
BACKGROUND: Disproportionate (d-) functional mitral regurgitation (FMR) is characterized by greater mitral regurgitation (MR) severity than expected from left ventricular (LV) dilatation. Morphological determinants of this imbalance remain unclear. METHODS AND RESULTS: /mL. CONCLUSIONS: Additional morphological factors were associated with greater MR severity beyond LV size and with residual MR after TEER, supporting a phenotype-based interpretation of FMR disproportionality.
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Arao et al. (2026) conducted an observational in Functional mitral regurgitation (n=114). Additional morphological factors (pseudo-prolapse, extreme mitral annular dilatation, deep indentation) vs. Fewer or no additional morphological factors was evaluated on Disproportionate functional mitral regurgitation (d-FMR) (OR 4.15, 95% CI 2.09-9.36, p=<0.001). The number of additional morphological factors present was independently associated with disproportionate functional mitral regurgitation (OR 4.15).
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