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Current Cardiology Reports

, 21:139 | Cite as

Treatment of Functional Mitral Regurgitation in Heart Failure

  • Enrico FabrisEmail author
  • Antonio De Luca
  • Giancarlo Vitrella
  • Davide Stolfo
  • Marco Masè
  • Renata Korcova
  • Marco Merlo
  • Serena Rakar
  • Arnoud W. J. van’t Hof
  • Elvin Kedhi
  • Andrea Perkan
  • Gianfranco Sinagra
Myocardial Disease (A Abbate and G Sinagra, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Myocardial Disease

Abstract

Purpose of Review

To analyze the current state of the art of functional mitral regurgitation (FMR) treatment.

Recent Findings

The first-line treatment of severe FMR consists of guideline medical therapy (GMT) and resynchronization therapy when indicated; the impact of new medical therapies like sacubitril/valsartan needs further assessment. Valvular intervention may be considered in FMR symptomatic patients despite GMT, and can be performed surgically or percutaneously. MitraClip is a safe percutaneous procedure associated with symptoms improvement. Recently, the COAPT trial showed superior outcomes for MitraClip versus GMT contrasting the MITRA-FR trial which showed no benefit of MitraClip compared with GMT. These results should be interpreted as complementary rather than opposite.

Summary

The COAPT trial provided a “proof of concept” that percutaneous treatment of severe FMR in patients without too advanced left ventricular disease translates into a prognostic benefit. Careful patient selection will play a critical role in defining the clinical niche for successful interventions.

Keywords

Functional mitral regurgitation Mitral valve repair Transcatheter interventions MitraClip Heart failure Heart team 

Notes

Compliance with Ethical Standards

Conflict of Interest

Enrico Fabris, Antonio De Luca, Giancarlo Vitrella, Davide Stolfo, Marco Masè, Renata Korcova, Marco Merlo, Serena Rakar, Elvin Kedhi and Andrea Perkan declare that they have no conflict of interest.

Arnoud WJ van’t Hof reports grants from Medtronic and Abbott, and personal fees from AstraZeneca.

Gianfranco Sinagra reports personal fees from Novartis, Vifor pharma, Boston, Bayer, AstraZeneca, and Dompè.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Enrico Fabris
    • 1
    Email author
  • Antonio De Luca
    • 1
  • Giancarlo Vitrella
    • 1
  • Davide Stolfo
    • 1
  • Marco Masè
    • 1
  • Renata Korcova
    • 1
  • Marco Merlo
    • 1
  • Serena Rakar
    • 1
  • Arnoud W. J. van’t Hof
    • 2
    • 3
  • Elvin Kedhi
    • 4
  • Andrea Perkan
    • 1
  • Gianfranco Sinagra
    • 1
  1. 1.Cardiovascular DepartmentUniversity of TriesteTriesteItaly
  2. 2.Department of CardiologyMaastricht University Medical CenterMaastrichtthe Netherlands
  3. 3.Department of CardiologyZuyderland Medical CenterHeerlenthe Netherlands
  4. 4.AZ Sint-Jan BruggeBrugesBelgium

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