Valvular & structural heart disease
Cardiac Remodeling and Outcomes of Patients With Combined Aortic and Mitral Regurgitation
Main finding · All-cause death, concomitant ≥moderate MRResult — go to the resultHazard ratio 2.77 95% CI 1.91–4.01Authors' conclusion
The presence of combined AR and MR on CMR is associated with a greater extent of ventricular remodeling and increased hazard for adverse outcomes, compared with isolated AR.
Study context
- Population
- Patients with moderate or severe AR on cardiac magnetic resonance (CMR), excluding prior valvular surgery, > mild valve stenosis, hypertrophic or infiltrative cardiomyopathy, or congenital heart disease except bicuspid aortic valve251 with concomitant MR
- Participants
- 915 patients
- Exposure
- Combined AR/MR vs isolated AR
- Outcome
- All-cause death
- Follow-up
- Median 3.0 years
Methodological detailsmulticentre, propensity-score matched
- Multicentre
- Propensity-score matched
Main finding
All-cause death, concomitant ≥moderate MR · median 3.0 years
Hazard ratio
2.77
95% CI 1.91–4.01
P < 0.001
Combined AR/MRvs isolated AR
HR 2.77 (95% CI 1.91–4.01); P < 0.001
As reported in the abstract
- Deaths
- 152
Observational data: associations, not effects.
Secondary outcomes
All-cause death or heart failure (HF) hospitalization, concomitant ≥moderate MR
| HR (95% CI) | P value | ||
|---|---|---|---|
| Concomitant ≥moderate MR | 2.62 (1.87–3.67) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Ventricular remodeling with concomitant ≥moderate MR
- Greater increase in ventricular volumes per unit increase in AR severity and decline in ventricular function
- P for interaction ≤ 0.01
Death and death or HF, asymptomatic or minimally symptomatic patients under medical surveillance (subgroup)
- Combined moderate AR and moderate MR independently associated with higher hazard vs isolated AR; consistent in propensity matched cohort
Original publication
Cardiac Remodeling and Outcomes of Patients With Combined Aortic and Mitral Regurgitation. JACC Cardiovasc Imaging. Published 31 October 2025. doi:10.
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