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Atrial secondary mitral regurgitation: prevalence, characteristics, management, and long-term outcomes

Sam Straw1,2, Ankit Gupta1, Kerryanne Johnson3

  • 1University of Leeds, Leeds, UK.

Echo Research and Practice
|March 7, 2023
PubMed
Abstract

Insights

Atrial secondary mitral regurgitation (ASMR) is common and linked to poor outcomes, particularly in older patients with comorbidities. Management strategies need to consider these factors for better patient prognosis.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Atrial secondary mitral regurgitation (ASMR) is not well-characterized regarding its prevalence, clinical features, management, and long-term prognosis.
  • Understanding ASMR is crucial for improving patient care and outcomes.

Purpose of the Study:

  • To investigate the prevalence, clinical characteristics, management, and long-term outcomes of patients with ASMR.
  • To compare ASMR with other causes of severe mitral regurgitation (MR).

Main Methods:

  • Retrospective, observational study of 388 patients with grade III/IV MR.
  • MR etiology classified as primary, ventricular SMR (VSMR), ASMR, or other.
  • Analysis of patient demographics, comorbidities, mortality, and heart failure hospitalizations.

Main Results:

  • ASMR accounted for 9.5% of severe MR cases.
  • ASMR patients were older, more frequently female, and had higher rates of atrial fibrillation.
  • ASMR was associated with the highest all-cause mortality and increased heart failure hospitalizations, though these were comparable to VSMR after adjusting for age and sex.

Conclusions:

  • ASMR is a prevalent condition with a distinct clinical profile.
  • ASMR is associated with a poor prognosis, largely driven by advanced age and comorbidities.
  • Further research into ASMR management is warranted.
Keywords:
Atrial fibrillationHeart failureMitral regurgitationSecondary mitral regurgitationValvular heart disease

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