Heart failure & cardiomyopathies
Mitral regurgitation and all-cause mortality in acute heart failure; a meta-analysis
Pooled result · All-cause mortality (unadjusted)Result — go to the resultOdds ratio 1.47 95% CI 1.30–1.66Authors' conclusion
We observed that MR during AHF is associated with increased mortality. Although causality cannot be inferred due to the observational design and high heterogeneity of the included studies, MR may represent a phenotype amenable to targeted therapies during decompensated heart failure.
Study context
- Population
- Acute heart failure (AHF) patients with mitral regurgitation (MR)27 studies, age 72.9±4.2years, females 44.4%, average follow-up of 1.9 years
- Participants
- 73,363 patients
- Comparison
- Moderate/severe MR compared to no/mild MR
- Outcome
- All-cause mortality (unadjusted)
- Follow-up
- Average 1.9 years
Pooled result
As reported in the abstract
Odds ratio
1.47
95% CI 1.30–1.66
P < 0.001
Moderate/severe MRvs no/mild MR
OR 1.47 (95% CI 1.30–1.66); P < 0.001
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality (studies reporting adjusted data)Moderate/severe MRvs no/mild MRAdjusted data | 1.21 (1.01–1.45) | P = 0.038 | |
| All-cause mortality by MR severityMild MRvs no MR | 1.22 (0.98–1.53) | P = 0.079 | |
| All-cause mortality by MR severityModerate MRvs no MR | 1.48 (1.1–2.01) | P = 0.011 | |
| All-cause mortality by MR severitySevere MRvs no MR | 1.60 (1.13–2.27) | P = 0.008 | |
| All-cause mortality by LVEF (subgroup)Moderate/severe MRvs no/mild MRLVEF <50% | 1.26 (1.18–1.35) | P < 0.001 | |
| All-cause mortality by LVEF (subgroup)Moderate/severe MRvs no/mild MRLVEF 40-50% | 2.00 (1.59–2.50) | P < 0.001 | |
| All-cause mortality by LVEF (subgroup)Moderate/severe MRvs no/mild MRLVEF >50% | 1.16 (0.91–1.47) | P = 0.23 | |
| 0.512Odds ratio (log scale) |
Meta-regression and sensitivity analyses
- Neither meta-regression nor pre-specified sensitivity analyses affected MR’s association with the primary outcome
- A substantial degree of heterogeneity was observed across the included studies
Original publication
Mitral regurgitation and all-cause mortality in acute heart failure; a meta-analysis. ESC Heart Fail. Published 4 August 2026. doi:10.
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