Treatment of Functional Mitral Regurgitation in Heart Failure

Enrico Fabris*, Antonio De Luca, Giancarlo Vitrella, Davide Stolfo, Marco Mase, Renata Korcova, Marco Merlo, Serena Rakar, Arnoud W. J. van't Hof, Elvin Kedhi, Andrea Perkan, Gianfranco Sinagra

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Citation (Web of Science)

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. 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.

Original languageEnglish
Article number139
Number of pages12
JournalCurrent Cardiology Reports
Volume21
Issue number11
DOIs
Publication statusPublished - Nov 2019

Keywords

  • Functional mitral regurgitation
  • Mitral valve repair
  • Transcatheter interventions
  • MitraClip
  • Heart failure
  • Heart team
  • CARDIAC RESYNCHRONIZATION THERAPY
  • NATIVE VALVULAR REGURGITATION
  • VALVE REPAIR
  • EUROPEAN ASSOCIATION
  • PERCUTANEOUS REPAIR
  • CLINICAL-OUTCOMES
  • ANNULOPLASTY
  • PREDICTORS
  • CARDIOMYOPATHY
  • IMPACT

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