Contemporary Management of Secondary Mitral Regurgitation
Secondary mitral regurgitation (SMR) is a common occurrence in patients with heart failure with reduced ejection fraction. Moderate-severe or severe SMR is associated with increased mortality and hospitalisations from heart failure. Medical and cardiac resynchronisation therapies have been the only...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Radcliffe Medical Media
2020-05-01
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| Series: | European Cardiology Review |
| Online Access: | https://www.ecrjournal.com/articleindex/ecr.2019.08 |
| _version_ | 1797200127269535744 |
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| author | Kashish Goel Colin M Barker JoAnn Lindenfeld |
| author_facet | Kashish Goel Colin M Barker JoAnn Lindenfeld |
| author_sort | Kashish Goel |
| collection | DOAJ |
| description | Secondary mitral regurgitation (SMR) is a common occurrence in patients with heart failure with reduced ejection fraction. Moderate-severe or severe SMR is associated with increased mortality and hospitalisations from heart failure. Medical and cardiac resynchronisation therapies have been the only treatments proven to improve prognosis in this patient population. The Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy (COAPT) and the Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation (MITRA-FR) RCTs evaluated transcatheter mitral valve repair with MitraClip for treatment of SMR in addition to medical therapy and they had divergent results. The COAPT trial demonstrated that a reduction in SMR with MitraClip resulted in reduced mortality and heart failure hospitalisations along with improved symptoms and quality of life in appropriately selected patients. The MITRA-FR trial did not show any benefit from using MitraClip for patients with SMR. This article summarises the differences in these two trials and suggests a contemporary approach to the management of SMR. |
| first_indexed | 2024-03-07T17:41:02Z |
| format | Article |
| id | doaj.art-86660e3d677343dcbbfa13e7747fbada |
| institution | Directory Open Access Journal |
| issn | 1758-3756 1758-3764 |
| language | English |
| last_indexed | 2024-04-24T07:26:42Z |
| publishDate | 2020-05-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | European Cardiology Review |
| spelling | doaj.art-86660e3d677343dcbbfa13e7747fbada2024-04-20T16:01:42ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642020-05-011510.15420/ecr.2019.08Contemporary Management of Secondary Mitral RegurgitationKashish Goel0Colin M Barker1JoAnn Lindenfeld2Vanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN, USVanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN, USVanderbilt Heart and Vascular Institute, Vanderbilt University School of Medicine, Nashville, TN, USSecondary mitral regurgitation (SMR) is a common occurrence in patients with heart failure with reduced ejection fraction. Moderate-severe or severe SMR is associated with increased mortality and hospitalisations from heart failure. Medical and cardiac resynchronisation therapies have been the only treatments proven to improve prognosis in this patient population. The Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy (COAPT) and the Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation (MITRA-FR) RCTs evaluated transcatheter mitral valve repair with MitraClip for treatment of SMR in addition to medical therapy and they had divergent results. The COAPT trial demonstrated that a reduction in SMR with MitraClip resulted in reduced mortality and heart failure hospitalisations along with improved symptoms and quality of life in appropriately selected patients. The MITRA-FR trial did not show any benefit from using MitraClip for patients with SMR. This article summarises the differences in these two trials and suggests a contemporary approach to the management of SMR.https://www.ecrjournal.com/articleindex/ecr.2019.08 |
| spellingShingle | Kashish Goel Colin M Barker JoAnn Lindenfeld Contemporary Management of Secondary Mitral Regurgitation European Cardiology Review |
| title | Contemporary Management of Secondary Mitral Regurgitation |
| title_full | Contemporary Management of Secondary Mitral Regurgitation |
| title_fullStr | Contemporary Management of Secondary Mitral Regurgitation |
| title_full_unstemmed | Contemporary Management of Secondary Mitral Regurgitation |
| title_short | Contemporary Management of Secondary Mitral Regurgitation |
| title_sort | contemporary management of secondary mitral regurgitation |
| url | https://www.ecrjournal.com/articleindex/ecr.2019.08 |
| work_keys_str_mv | AT kashishgoel contemporarymanagementofsecondarymitralregurgitation AT colinmbarker contemporarymanagementofsecondarymitralregurgitation AT joannlindenfeld contemporarymanagementofsecondarymitralregurgitation |