{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:48:44Z","timestamp":1785836924425,"version":"3.56.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Despite previous studies investigating the impact of mitral regurgitation (MR) in acute heart failure (AHF) there are inconsistencies in trial data, and no meta-analyses to date. Our aim was to explore if MR is associated with mortality in AHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We performed a meta-analysis of AHF patients with MR to investigate any association with all-cause mortality. We identified 27 studies that met our inclusion criteria, encompassing 73,363 patients (age 72.9\u00b14.2years; females 44.4%) with an average follow-up of 1.9 years. Moderate\/severe MR was associated with an unadjusted 47% increased mortality risk compared to no\/mild MR (OR 1.47 [95% CI 1.30-1.66, p&amp;lt;0.001]). This excess risk of death persisted among studies reporting adjusted data (OR 1.21 [95% CI 1.01-1.45, p=0.038]). Compared to those with no MR, MR severity was associated with increasing risk of death: mild MR OR 1.22 [95% CI 0.98-1.53, p=0.079], moderate MR OR 1.48 [95% CI 1.1-2.01, p=0.011] and severe MR OR 1.60 [95% CI 1.13-2.27, p=0.008]. We observed excess mortality in moderate\/severe MR compared to no\/mild MR among individuals with a left ventricular ejection fraction (LVEF) &amp;lt;50% (OR 1.26 [95% CI 1.18-1.35, p&amp;lt;0.001]) and LVEF 40-50% (OR 2.00 [95% CI 1.59-2.50, p&amp;lt;0.001]) but not LVEF &amp;gt;50% (OR 1.16 [95% CI 0.91-1.47, p=0.23]. Neither meta-regression nor pre-specified sensitivity analyses affected MR\u2019s association with the primary outcome. A substantial degree of heterogeneity was observed across the included studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We observed that MR during AHF is associated with increased mortality. Although causality cannot be inferred due to the observational design and high heterogeneity of the included studies, MR may represent a phenotype amenable to targeted therapies during decompensated heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag200","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:19:20Z","timestamp":1785755960000},"source":"Crossref","is-referenced-by-count":0,"title":["Mitral regurgitation and all-cause mortality in acute heart failure; a meta-analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6079-1471","authenticated-orcid":false,"given":"Max","family":"Berrill","sequence":"first","affiliation":[{"name":"Department of Research & Development, St Peter\u2019s Hospital , Chertsey ,","place":["UK"]},{"name":"Department of Echocardiography, Harefield Hospital , Harefield ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meric","family":"Bengisu","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Harefield Hospital , Harefield ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantina","family":"Kipourou","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, Harefield Hospital , Harefield ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gie","family":"Ken Dror","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Research, Holloway University , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Coles","sequence":"additional","affiliation":[{"name":"Bart\u2019s Health Knowledge and Library Services, St Bartholomew\u2019s Hospital , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2856-6180","authenticated-orcid":false,"given":"Isaac","family":"John","sequence":"additional","affiliation":[{"name":"Department of Research & Development, St Peter\u2019s Hospital , Chertsey ,","place":["UK"]},{"name":"Institute of Cardiovascular Research, Holloway University , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Research & Development, St Peter\u2019s Hospital , Chertsey ,","place":["UK"]},{"name":"Institute of Cardiovascular Research, Holloway University , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aigul","family":"Baltabaeva","sequence":"additional","affiliation":[{"name":"Department of Research & Development, St Peter\u2019s Hospital , Chertsey ,","place":["UK"]},{"name":"Department of Echocardiography, Harefield Hospital , Harefield ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,4]]},"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article-pdf\/doi\/10.1093\/eschf\/xvag200\/70476589\/xvag200.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article-pdf\/doi\/10.1093\/eschf\/xvag200\/70476589\/xvag200.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:41:05Z","timestamp":1785836465000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/advance-article\/doi\/10.1093\/eschf\/xvag200\/8750835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/eschf\/xvag200","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"article-number":"xvag200"}}