Heart failure & cardiomyopathiesMeta-analysis
Mitral regurgitation and all-cause mortality in acute heart failure; a meta-analysis
- meta-analysis
Authors' 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
Pooled result
All-cause mortality (unadjusted) · average follow-up of 1.9 years
Odds ratio
1.47
95% CI 1.30–1.66
P < 0.001
Moderate/severe MR vs no/mild MR
OR 1.47 (95% CI 1.30–1.66); P < 0.001
As reported in the abstract
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality (studies reporting adjusted data) · adjusted data | 1.21 (1.01–1.45) | P = 0.038 | |
| All-cause mortality by MR severity — mild MR vs no MR | 1.22 (0.98–1.53) | P = 0.079 | |
| All-cause mortality by MR severity — moderate MR vs no MR | 1.48 (1.1–2.01) | P = 0.011 | |
| All-cause mortality by MR severity — severe MR vs no MR | 1.60 (1.13–2.27) | P = 0.008 | |
| All-cause mortality by LVEF (subgroup) — Moderate/severe MR vs no/mild MR · LVEF <50% | 1.26 (1.18–1.35) | P < 0.001 | |
| All-cause mortality by LVEF (subgroup) — Moderate/severe MR vs no/mild MR · LVEF 40-50% | 2.00 (1.59–2.50) | P < 0.001 | |
| All-cause mortality by LVEF (subgroup) — Moderate/severe MR vs no/mild MR · LVEF >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:10.1093/eschf/xvag200
Summarised from the published abstract; every number is checked against it