IMR Press / RCM / Volume 24 / Issue 11 / DOI: 10.31083/j.rcm2411316
Open Access Original Research
The Prognostic Significance of Secondary Mitral Regurgitation in Heart Failure Patients with Varying Estimated Pulmonary Artery Systolic Pressure
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1 Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025 Shanghai, China
*Correspondence:; (Qin Fan); (Rong Tao)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(11), 316;
Submitted: 31 March 2023 | Revised: 18 June 2023 | Accepted: 27 June 2023 | Published: 16 November 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Limited research has been conducted to investigate the impact of secondary mitral regurgitation (MR) in heart failure (HF) patients with different levels of estimated pulmonary artery systolic pressure (ePASP). Methods: A total of 468 patients suffering from HF and secondary MR were enrolled and categorized into non-severe and severe MR groups based on the degree of MR. The primary endpoint of the study was a composite of cardiovascular death and a first-heart-failure hospitalization. The secondary endpoints were the primary outcomes, individually. The outcomes of the two groups were compared. Patients were further classified based on whether their ePASP was 50 mmHg or <50 mmHg. Subsequently, the outcomes of the non-severe and severe MR groups were compared within each ePASP category. Results: In a median (SD) follow-up of 694 (410) days, severe MR was associated with higher risk for primary endpoints in patients with heart failure, especially in those with ePASP 50 mmHg. In patients with ePASP <50 mmHg, the prognostic value of severe MR was diminished. Conclusions: Assessment of the severity of MR can identify heart failure patients who are at greater risks for poor clinical outcomes. Additionally, the prognostic value of secondary MR was more pronounced in patients with elevated ePASP.

heart failure
pulmonary hypertension
pulmonary artery systolic pressure
secondary mitral regurgitation
82000368/National Natural Science Foundation of China
81970327/National Natural Science Foundation of China
82270383/National Natural Science Foundation of China
Fig. 1.
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