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Moderate Secondary Mitral Regurgitation: Evolving Evidence and Management Strategies
Mauro Riccardi1, Matteo Pagnesi2, Carlo M Lombardi1
1Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiologic Sciences and Public Health, University of Brescia, Brescia, Italy; Cardiology Division, ASST Cremona, Cremona, Italy.
Journal of the American College of Cardiology
|September 10, 2025
Summary
Secondary mitral regurgitation (SMR) affects many heart failure (HF) patients. This review explores moderate SMR prevalence, its impact, and treatment options, highlighting potential benefits of transcatheter correction.
Area of Science:
- Cardiology
- Interventional Cardiology
- Heart Failure Management
Background:
- Secondary mitral regurgitation (SMR) is a frequent complication in heart failure (HF) patients.
- Current research often prioritizes severe SMR, potentially underestimating moderate SMR's clinical significance.
Purpose of the Study:
- To review the prevalence of moderate SMR in heart failure.
- To assess the prognostic impact of moderate SMR.
- To discuss current and emerging treatment strategies for moderate SMR.
Main Methods:
- Literature review of studies focusing on moderate SMR in HF.
- Analysis of data from trials like RESHAPE-HF2 regarding moderate and severe SMR.
- Synthesis of evidence on pharmacologic and interventional management.
Main Results:
- Moderate SMR is prevalent in HF populations.
- Evidence suggests moderate SMR carries prognostic implications.
- Transcatheter approaches show potential for moderate SMR, warranting further investigation.
Conclusions:
- Moderate SMR requires clinical attention due to its prevalence and impact in HF.
- Further research is needed to establish optimal interventional strategies for moderate SMR.
- Pharmacologic and interventional options are evolving for managing moderate SMR in HF.
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