• 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 Pok-Tin Tang Dr Pok-Tin Tang is an ST5 cardiology registrar in the Thames Valley deanery, currently undertaking a period of out of
Author Sub-editor: Dr May Hu Dr May Hu is a cardiology trainee in the North West deanery. She graduated with First Class Honours from the University
Author Sub-editor: Dr Jhiamluka Solano Dr Jhiamluka Solano is a cardiology resident doctor (ST6) in the Yorkshire and Humber Deanery, currently undertaking a DPhil (PhD)
Author Sub-editor: Dr Joshua Rowland Dr Joshua Rowland is a cardiology registrar working in the North West Deanery. He graduated from the University of Manchester
Author Sub-editor: Dr Atmadeep Banerjee Dr Atmadeep Banerjee is an ST4 Cardiology Registrar in the Kent, Surrey and Sussex deanery. He graduated from Calcutta National
