Valvular & structural heart disease
Natural History and Outcomes of Patients With Moderate and Moderate-Severe Mitral Regurgitation
Authors' conclusion
Patients with moderate or moderate-severe MR accrue significant mortality and morbidity over follow-up. Further trials are needed to ascertain the indication, optimal timing and method of procedural intervention.
Study context
- Population
- Consecutive patients with moderate or moderate-severe mitral regurgitation (MR) who underwent echocardiography at Mayo Clinic between 2010 and 2023mean age 70.7 ± 13.7 years, 45.1% female, median follow-up 4.1 years (Q1-Q3: 2.3–7.9)
- Participants
- 8,687 patients
- Exposure
- Functional MR vs degenerative MR
- Outcome
- All-cause mortality (overall survival)
- Follow-up
- 4 years
Methodological detailsconsecutive patients, single-centre (Mayo Clinic)
- Consecutive patients
- Single-centre (Mayo Clinic)
Main finding
As reported in the abstract
- Overall survival
- 68.5% (95% CI: 67.4%-69.7%)
Observational data: associations, not effects.
Secondary outcomes
MR progression to severe MR
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| Functional MRLess common in functional MR | 0.65 (0.54–0.79) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Mitral valve intervention
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| Functional MRSignificantly less common in functional MR | 0.45 (0.37–0.56) | P < 0.001 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Cumulative incidence
| Outcome | Degenerative MR | Functional MR |
|---|---|---|
| HF hospitalization (cumulative incidence) · 4 years | 17.9% (95% CI 15.7%–20%) | 36.8% (95% CI 35.6%–38.1%) |
- MR progression to severe MR — MR progression occurred
- 32.7% (95% CI: 31.0%-34.4%)
- Mitral valve intervention — Mitral valve intervention
- 11.4% (95% CI: 10.6%-12.1%)
Heart failure (HF) hospitalization (cumulative incidence) · 4 years
- Risk of HF hospitalization similar after multivariable adjustments
Original publication
Natural History and Outcomes of Patients With Moderate and Moderate-Severe Mitral Regurgitation. JACC Adv. Published 23 July 2026. doi:10.
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