Moderate Secondary Mitral Regurgitation: Not Clearly Benign, Not Clearly Actionable

Take home messages

• Moderate secondary mitral regurgitation (SMR) is common in heart failure (HF) and associated with adverse outcomes, but its prognostic impact remains uncertain in heart failure with preserved ejection fraction, in part due to inconsistent grading
• Guideline-directed medical therapy (GDMT) remains the mainstay of management as with HF without valve disease
• Recent data suggest symptomatic improvement and reduction in HF hospitalisations with mitral transcatheter edge-to-edge repair (M-TEER) but are yet to demonstrate definitive mortality benefit in moderate SMR
• Future trials should focus on multi-parametric echocardiographic criteria and optimised GDMT before randomisation to clarify whether moderate SMR is a useful treatment target

Author

  • Sub-editor:

    Dr Chi Ho Fung graduated with Distinction from Imperial College School of Medicine in 2019 with an Intercalated Bachelor of Science Degree in Cardiovascular Science and completed Internal Medical Training in South London. He is currently an ST4 trainee in Kent with a subspecialty interest in imaging and electrophysiology. He has a Postgraduate Certificate in Clinical Education, and is passionate about teaching in simulated environments. His research interests include being a sub-investigator in a clinical trial investigating physiological pacing versus right ventricular pacing. He has co-authored original research articles in the fields of coronary intervention, electrophysiology, and medical education.

Related articles