Valvular & structural heart disease
Differences in patterns of progression of secondary mitral regurgitation
Authors' conclusion
Based on disease progression, two distinct progression patterns of SMR exist, having different anatomical and mechanistic features with variation in management and outcomes.
Study context
- Population
- Patients with chronic severe secondary MR with at least one previous transthoracic echocardiography showing non-severe MR
- Participants
- 257 patients
- Exposure
- Cluster 1 vs Cluster 2
- Outcome
- Progression phenotypes of SMR
Methodological detailsunsupervised phenotypic clustering
- Unsupervised phenotypic clustering
Main finding
As reported in the abstract
- Cluster 1 started with lower ejection fraction (EF) and left atrial (LA) strain and higher left ventricular (LV) and LA volumes vs Cluster 2, with slower progression into severe secondary mitral regurgitation (SMR)
- At onset of severe MR, Cluster 2 had higher EF, lower LV volumes, similar LA volumes and strain, and less proportionate SMR vs Cluster 1
- Cluster 2 had higher tenting height and more compensatory leaflet growth
Observational data: associations, not effects.
Further findings
Management on follow-up
- Cluster 1 had more ventricular-directed therapies; Cluster 2 received more mitral valve interventions
HF burden and mortality
- HF burden higher in Cluster 1
- No difference in mortality rates
Original publication
Differences in patterns of progression of secondary mitral regurgitation. Eur Heart J Cardiovasc Imaging. Published 18 October 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →