{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:09:51Z","timestamp":1788480591640,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4t Augsburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and aims<\/jats:title>\n            <jats:p>The impact of mitral regurgitation (MR) in asymptomatic patients is not well defined. We aimed to determine the prevalence of MR-related complications and their association with 10-year survival in a large unselected asymptomatic MR cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Health insurance claims data from Germany\u2019s second largest health insurance fund, BARMER, which maintains longitudinal data on 8.7 million German residents, were retrospectively analyzed. All patients with an outpatient diagnosis of MR in a minimum of two quarters during a calendar year and first recorded diagnosis between 2008 and 2011 were included. Patients with any complication attributable to MR or mitral valve intervention at index were excluded. Outcomes were compared between study group and age- and sex-matched controls (i.e., without known cardiac disease). MR-related complications of interest were new congestive heart failure, new-onset atrial fibrillation, pulmonary hypertension, or cardiac decompensation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 56,577 individuals (median age 68 years, 67% female) with asymptomatic MR were identified. At 10 years, MR-related complications were more frequent in the study group vs. control group (46.5% vs. 20.8%, OR 3.31, P\u2009&lt;\u20090.0001). Furthermore, MR-related complications were more common in male vs. female patients with an asymptomatic MR (OR 2.65, P\u2009&lt;\u20090.0001). The occurrence of at least one MR-related complication was associated with a reduced 10-year survival (OR 1.80, P\u2009&lt;\u20090.0001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Almost half of patients with asymptomatic MR experience complications during a 10 year follow-up which result in impaired survival. These results imply the necessity of long-term disease management program. Furthermore, decision-making process and timing for mitral valve intervention in asymptomatic patients should be reevaluated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00392-024-02532-0","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T09:02:56Z","timestamp":1724835776000},"page":"856-866","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prognostic impact of disease-related complications in asymptomatic mitral regurgitation: a health insurance claims analysis"],"prefix":"10.1007","volume":"114","author":[{"given":"L.","family":"Acar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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S.B. is past president of the German Society for Cardiology and Cardiovascular Research. V.F. discloses consulting for Medtronic, Abbott, Edwards Lifesciences, Novartis, LivaNova, Biotronik, Boston Sc., Berlin Heart, Artivion, Zurich Heart and grants from Abbott, LivaNova, Medtronic, Edwards, Patent: United States Patent No. 6,468,265, \u201cPerforming cardiac surgery without cardioplegia\u201d, United States Patent No. 6,398,726, \u201cStabilizer for robotic beating-heart surgery\u201d, German Utility Patent No. 299 23 269.7, \u201cEndoscopic pressure stabilizer\u201d, United States Patent No. 08,0265, \u201cMethod of imaging for heart valve implant procedure\u201d, European Patent No EP 12175533.4, \u201cMethod for Determining Contact Forces between a Deformable Implant and Surrounding Tissue\u201d, European Patent No EP16158181.4\u20131651, \u201cBiomedical Apparatus with a pressure regulated blood pump\u201d, European Patent No EP15 17 7575.6, \u201cImplantable pump system and methods for placing a pump system\u201d, Deutsche Gebrauchsmuster Amt. AkZ: 20 2015 009 444, \u201cImplantierbares Pumpsystem\u201d. The other authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Our study adheres to the 2013 Helsinki Declaration. Multiple review boards on consensus guidelines have determined that using anonymized data from claims or national statistics retrospectively does not constitute human subject research, as de-identified datasets were utilised.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All analyses were following the European Union General Data Privacy Regulation, considering the theoretical concept of k-anonymity. Thus, patient informed consent was not obtained for this retrospective secondary data analysis.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}