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Updated: Jun 8, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Long-term prognostic value of mitral regurgitation in acute coronary syndromes
Anita Persson1, Marianne Hartford, Johan Herlitz
1Department of Clinical Physiology, Sahlgrenska Academy and University Hospital, Gothenburg, Sweden
Objectives:
To determine the additional prognostic value of mitral regurgitation (MR) over B-type natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and clinical characteristics in patients with acute coronary syndromes (ACS).
Design:
Long-term follow-up in a prospective ACS cohort with Doppler-assessed MR, echocardiographically-determined LVEF and plasma BNP levels by ELISA.
Setting:
Single-centre university hospital.
Patients:
725 patients with ACS.
Main Outcome Measures:
Death and readmission for congestive heart failure.
Results:
During a median follow-up of 98 months, 235 patients (32%) died. Significant MR (grade >1 of 4) was found in 90 patients (12%). In a multivariate model including MR grade >1, LVEF <0.40 and BNP >373 pg/ml (75th percentile), MR was significantly associated with long-term mortality (HR 2.28, 95% CI 1.67 to 3.12; p<0.0001). When also adjusting for conventional risk factors, MR remained significantly associated with mortality (HR 1.53, 95% CI 1.06 to 2.19; p=0.02), as well as with congestive heart failure (HR 2.08, 95% CI 1.29 to 3.35; p=0.003).
Conclusions:
MR is common in patients with ACS, provides independent risk information and should be taken into account in the evaluation of the long-term prognosis.
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