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Current Insights Into Secondary Mitral Regurgitation—Workup and Management

  • Valvular Heart Disease (J Dal-Bianco, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

To outline a comprehensive clinical evaluation of secondary mitral regurgitation (SMR) and to review the state-of-the-art, diagnostic advances, therapeutic challenges, and future developments.

Recent findings

SMR is commonly observed in heart failure patients. With an increasing heart failure incidence in an aging population, the prevalence of SMR is expected to rise significantly. SMR is associated with more symptoms, increased hospitalizations for heart failure, and overall worse prognosis. Both diagnostic approach and therapeutic management are challenging, but recent studies provide solutions and significant developments in this rapidly evolving field.

Summary

SMR is a complex valvular heart disease, affecting a significant proportion of heart failure patients, and is associated with a worse prognosis. Key challenges are refinement of diagnostic assessment to improve patient selection for the respective therapeutic approach. Mastering the challenge of SMR requires a multidisciplinary collaborative effort, both in clinical practice and scientific approach to optimize patient outcomes.

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Abbreviations

CRT:

Cardiac resynchronization therapy

EROA:

Effective regurgitant orifice area

GDMT:

Guideline-directed medical therapy

HFmrEF:

Heart failure with mid-range ejection fraction (LVEF 40–49%)

HFrEF:

Heart failure with reduced ejection fraction (LVEF < 40%)

HF:

Heart failure

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

MR:

Mitral regurgitation

MV:

Mitral valve

RF:

Regurgitant fraction

RVol:

Regurgitant volume

SMR:

Secondary mitral regurgitation

VCW:

Vena contracta width

References and Recommended Reading

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

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Authors and Affiliations

  1. Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria

    Gregor Heitzinger, Martin Hülsmann MD, Julia Mascherbauer MD, Stefan Kastl MD, Christian Hengstenberg MD, Georg Goliasch MD, PhD & Philipp E. Bartko MD, PhD

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  1. Gregor Heitzinger
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Correspondence to Philipp E. Bartko MD, PhD.

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Gregor Heitzinger, Martin Hülsmann, Julia Mascherbauer, Stefan Kastl, Christian Hengstenberg, Georg Goliasch, and Philipp E. Bartko declare that they have no conflict of interest.

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Heitzinger, G., Hülsmann, M., Mascherbauer, J. et al. Current Insights Into Secondary Mitral Regurgitation—Workup and Management. Curr Treat Options Cardio Med 22, 29 (2020). https://doi.org/10.1007/s11936-020-00826-w

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