One potential therapeutic concept for treating heart failure besides guideline directed medical therapy, is to correct any concomitant severe mitral valve insufficiency (mitral regurgitation). Despite numerous treatment options being available, it is still not clear which patients will benefit most from such an intervention.
The long-term observational study conducted by Georg Goliasch from the Division of Cardiology, MedUni Vienna/Vienna General Hospital, observed the impact of functional mitral regurgitation (heart valve defect) on the long-term prognosis of 576 patients with chronic systolic heart failure. It was found that the increasing prevalence (occurrence) of functional mitral regurgitation is directly related to the severity of heart failure. Moreover, the results reinforce the hypothesis that functional mitral regurgitation has an adverse impact upon long-term survival of heart failure patients, irrespective of other clinical, echocardiographic or neurohumoral factors.
The exact time of the intervention is crucial
However, perhaps the most important finding in this context is that mitral regurgitation primarily influences the survival of those patients whose heart failure is not yet very advanced. This indicates that there is a particular "window of opportunity" that should be used to make an appropriate intervention.
This study underscores the growing importance of functional mitral regurgitation in the setting of chronic heart failure and indicates, for the first time, which patients can subsequently benefit from interventional treatment of functional mitral regurgitation. It was hitherto impossible to demonstrate with such clarity that there is a "too early" and "too late" for an intervention and this knowledge takes us one step further towards precision medicine.
Chronic heart failure (cardiac insufficiency) is a growing challenge for Western societies, due to its frequency and its impact in terms of hospital admissions and mortality. It is more common than a heart attack and represents a much higher risk for those affected. For this reason, heart failure is currently the major area of interest for the European Society of Cardiology. In May of this year, more than 5,000 cardiologists are expected in Vienna to attend two specialist congresses.
Specialist congresses in Vienna
Herzinsuffizienz 2018 – Germany-Austria-Switzerland three-country meeting, 25 – 26 May 2018, in MedUni Vienna Lecture Center within Vienna General Hospital: http://www.herzinsuffizienz-d-a-ch.org/
Heart Failure 2018 – European Society of Cardiology Congress, 26 – 29 May 2018, in Vienna Exhibition & Congress Centre: www.escardio.org/heartfailure
European Heart Journal
Goliasch G, Bartko PE, Pavo P, Neuhold S, Wurm R, Mascherbauer J, Lang IM, Strunk G, Hülsmann M. Refining the prognostic impact of functional mitral regurgitation in chronic heart failure. Eur Heart J 2018 Jan 1;39:39-46