Heart failure & cardiomyopathies

Mitral regurgitation in patients with heart failure and reduced ejection fraction: insights from GALACTIC-HF

Eur J Heart FailPublished Secondary analysis of the GALACTIC-HF randomised trial

Corrected 23 Oct 2026: The values shown beside the hazard ratio were the prevalence of each mitral regurgitation grade (the groups' sizes), not the outcome's rate; removed.

Primary result · Primary outcome (first HF event or CV death)Result — go to the resultAdjusted hazard ratio 1.11 95% CI 1.01–1.23

Authors' conclusion

In GALACTIC-HF, almost 15% of patients with heart failure and reduced ejection fraction had moderate MR, which was associated with a higher risk of the primary outcome.

Study context

Population
Patients with HFrEF in the GALACTIC-HF trial (omecamtiv mecarbil vs placebo)with baseline mitral regurgitation (MR) data
Participants
7,998 patients
Comparison
Moderate MR vs no MR
  • No MRn = 5,782reference
  • Mild MRn = 970
  • Moderate MRn = 1,221
Primary endpoint
Composite of:
  • First HF event
  • CV death

Primary result

Primary outcome:

  • First HF event
  • CV death

Adjusted hazard ratio

1.11

95% CI 1.01–1.23

Moderate MRvs No MR
adjusted HR 1.11 (95% CI 1.01–1.23)

As reported in the abstract

Further findings

Moderate MR and primary outcome, by HF severity (subgroup)

Association most prominent in less severe HF (milder NYHA class, higher LVEF, lower NT-proBNP)

Mortality

MR not associated with mortality in adjusted analyses

Omecamtiv mecarbil treatment effect by MR

Beneficial treatment effect not modified by MR

Eligibility for COAPT and RESHAPE-HF2 (moderate/severe MR)

Fulfilled broad inclusion criteria
Over 80%

Original publication

Mitral regurgitation in patients with heart failure and reduced ejection fraction: insights from GALACTIC-HF. Eur J Heart Fail. Published 14 January 2026. doi:10.1093/ejhf/xuag007

Composed by AI from the published abstract and checked against it. How Briefs are made →

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