2017
DOI: 10.1093/eurheartj/ehx402
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Refining the prognostic impact of functional mitral regurgitation in chronic heart failure

Abstract: In a patient cohort under OMT, the adverse prognostic impact of FMR is given predominantly in a sub-cohort of a specific intermediate-failure phenotype-well-defined functionally, haemodynamically, biochemically, and morphologically.

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Cited by 285 publications
(239 citation statements)
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References 30 publications
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“…An increasing body of evidence consolidates the impact of sMR on the failing LV and long‐term outcome even in patients under GDT . Importantly, recent data illustrate the progressive nature of sMR to be a key feature that drives mortality in HFrEF patients .…”
Section: Discussionmentioning
confidence: 94%
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“…An increasing body of evidence consolidates the impact of sMR on the failing LV and long‐term outcome even in patients under GDT . Importantly, recent data illustrate the progressive nature of sMR to be a key feature that drives mortality in HFrEF patients .…”
Section: Discussionmentioning
confidence: 94%
“…Importantly, recent data illustrate the progressive nature of sMR to be a key feature that drives mortality in HFrEF patients . In fact, progressive sMR occurs in 20%‐30% of patients with nonsevere sMR despite GDT and is independently associated with a more than twofold increased risk of death . Defining patients at risk for progression is mandatory as in this patient subpopulation more invasive early treatment strategies are available but the level of evidence in guideline recommendations is weak .…”
Section: Discussionmentioning
confidence: 99%
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“…Mild or even moderate functional mitral regurgitation (MR) is commonly observed in patients with HFpEF, but is often considered to be a bystander rather than contributor to pathophysiology. In HF with reduced ejection fraction (HFrEF), increasing MR severity is associated with greater symptom burden, hospitalization risk, and mortality . In these patients functional MR develops secondary to tethering of the mitral leaflets caused by dislocation of the papillary muscles and chordae tendinae, with impaired closing due to contractile dysfunction, and annular enlargement caused by left ventricular (LV) dilatation .…”
Section: Introductionmentioning
confidence: 99%
“…FMR results from various LV remodelling mechanisms that prevent coaptation of structurally normal valve leaflets . FMR multiplies the risk of HF decompensation and death by roughly two depending on the HF patient population . Because of its volatile nature in time and the variety of underlying mechanisms causing mitral regurgitation (MR), the management of HF patients with FMR is complex.…”
Section: Main Differences Between Coapt and Mitra‐fr To Explain The Cmentioning
confidence: 99%