Heart failure & cardiomyopathiesCohort study
Impact of contemporary guideline-directed medical therapy on secondary mitral and tricuspid regurgitation in heart failure with reduced ejection fraction
- Cohort study
Authors' conclusion
In patients with a recent diagnosis of HFrEF receiving contemporary GDMT, the majority of patients with ≥moderate secondary MR and TR achieved regression of MR/TR, and the minority of patients without significant baseline MR/TR developed ≥moderate regurgitation at follow-up.
Study context
- Population
- Patients with <1 year diagnosis of HFrEF (mildly 40%≤EF<50% or moderately <40% reduced EF) in a GDMT titration program, 2019–2024
- Participants
- 844 patients
- Outcome
- Regression of ≥moderate secondary MR/TR to ≤mild and development of incident ≥moderate MR/TR
Main finding
As reported in the abstract
Regression of ≥moderate MR to no/mild MR (median 7.1 months)
171 (75%)
Regression of ≥moderate TR to no/mild TR (median 7.1 months)
87 (75%)
Incident ≥moderate MR in no/mild baseline MR (median 13 months)
5%
Incident ≥moderate TR in no/mild baseline TR (median 13 months)
6%
Observational data: associations, not effects.
Further findings
Baseline prevalence of ≥moderate MR and TR
- ≥moderate MR
- 28%
- ≥moderate TR
- 14%
Number of GDMT medications at follow-up
- Fewer GDMT medications in patients without MR/TR regression and in those who developed MR/TR
Subgroup: NYHA I/II vs NYHA III/IV
- Similar number of GDMT and similar rates of MR and TR regression and development
Subgroup: mildly vs moderately reduced EF
- Mildly reduced EF received fewer GDMT medications and had less MR regression
Original publication
Summarised from the published abstract; every number is checked against it