Therapeutic options for functional mitral regurgitation in chronic heart failure

Expert Rev Med Devices. 2018 May;15(5):357-365. doi: 10.1080/17434440.2018.1473032. Epub 2018 May 8.

Abstract

Introduction: Mitral regurgitation is a common finding in patients with chronic heart failure and is associated with a progressive worsening of symptoms, reduced survival and increased cost of care. However, the use of mitral valve surgery for these patients remains controversial and has not been shown to improve survival. Consequently, research has been increasingly directed towards the nonsurgical management of this important co-morbidity of heart failure.

Areas covered: The present review will describe the relevance of mitral regurgitation in people with chronic heart failure, the current options for percutaneous treatment and the evidence base for each of these.

Expert commentary: Although at present there are few solid data to guide heart teams in deciding what degree of mitral regurgitation to treat, in which patients, and with what, this situation is likely to change over the next two years with the release of the first large randomised trials of percutaneous interventions.

Keywords: Heart failure; mitral regurgitation; morbidity; percutaneous therapies; prognosis.

Publication types

  • Review

MeSH terms

  • Cardiac Resynchronization Therapy
  • Chronic Disease
  • Heart Failure / complications*
  • Heart Failure / therapy*
  • Heart Valve Prosthesis Implantation
  • Humans
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / mortality
  • Mitral Valve Insufficiency / physiopathology*
  • Mitral Valve Insufficiency / therapy*