Fill in the Gaps of Secondary Mitral Regurgitation: a Continuum Challenge From Pathophysiology to Prognosis

Mitral regurgitation (MR) is one of the most frequent valvular heart diseases encountered in clinical practice. In contrast to primary MR, less is still known about the pathophysiology, diagnosis, and prognosis of secondary MR. The purpose of this report is to provide a review, upon the last knowledge reported in the literature, on the role and management of secondary MR in clinical practice.

Recent data highlight secondary MR not as a single pathological entity but as a wide spectrum of interconnected conditions which portend poor outcome. Although the role of secondary MR on clinical outcome is debated, recent available data suggest an independent association of MR with prognosis. Nevertheless, available treatment did not show a clear benefit after MR correction. Further studies are needed to better categorize and assess secondary MR beyond schematic classification. A management approach should be tailored upon each clinical context of presentation.