{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T12:45:03Z","timestamp":1767012303623,"version":"3.48.0"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To understand prognostic differences between sexes in (subtypes of) secondary mitral valve regurgitation (SMR) and to identify avenues for improvement.<\/jats:p>\n <\/jats:sec>\n \n Method and results<\/jats:title>\n \n In this retrospective study, all consecutive patients diagnosed with moderate or severe SMR by echocardiographic assessment between January 1, 2014, and June 1, 2021 were included. Sex\u2010specific analyses were performed using Cox proportional hazards analysis, adjusted for significant covariates. A total of 1245 patients with SMR (43% female) were included. Females more often had atrial SMR (233 (29%) females vs. 200 (21%) males,\n p<\/jats:italic>\n \u00a0<\u00a00.01), males more often ischemic SMR (100 females (12%) vs. 245 males (25%),\n p<\/jats:italic>\n \u00a0<\u00a00.01), and there were no significant differences between sexes in the proportion of non\u2010ischemic SMR (199 (25%) females vs. 268 (28%) males,\n p<\/jats:italic>\n \u00a0=\u00a00.99). The estimated 5\u2010year survival was 70% (CI\u00a0=\u00a068%, 73%). Median follow\u2010up was 4.3 years [2.7\u20136.2], 236 males and 128 females died during follow\u2010up. Females had a better survival than males in a multivariable Cox model (HR = 0.67,\n p<\/jats:italic>\n \u00a0<\u00a00.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Overall survival in patients with SMR was low with an estimated 5\u2010year survival of 70%. Females had a better survival in patients with SMR than males. The lower survival in males with SMR might be due to a larger proportion of atrial SMR in females, fewer patients with ischemic SMR, and lower ejection fractions in males with non\u2010ischemic SMR. The current focus on rapid heart failure medication optimization may improve the prognosis of the most vulnerable group; future studies can be directed to see whether this will be the case.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/echo.70370","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T13:05:41Z","timestamp":1765803941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Prognosis of Males and Females With Moderate or Severe Secondary Mitral Valve Regurgitation and Avenues for Improvement"],"prefix":"10.1111","volume":"42","author":[{"given":"Jelle P.","family":"Man","sequence":"first","affiliation":[{"name":"Department of Cardiology Amsterdam UMC Amsterdam the Netherlands"},{"name":"Netherlands Heart Institute Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berto J.","family":"Bouma","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC Amsterdam the Netherlands"},{"name":"Netherlands Heart Institute Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. A.","family":"Molenaar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC Amsterdam the Netherlands"},{"name":"Netherlands Heart Institute Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven A. J.","family":"Chamuleau","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam UMC Amsterdam the Netherlands"},{"name":"Netherlands Heart Institute Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.","family":"Schuuring","sequence":"additional","affiliation":[{"name":"Netherlands Heart Institute Utrecht the Netherlands"},{"name":"Department of Cardiology Medical Spectrum Twente Enschede the Netherlands"},{"name":"Department of Biomedical Signals and Systems University of Twente Enschede the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw229"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30473-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/EURHEARTJ\/EHAB395"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz314"},{"key":"e_1_2_7_7_1","first-page":"628","article-title":"Mitral Valve Regurgitation in the Contemporary Era: Insights Into Diagnosis, Management, and Future Directions","volume":"11","author":"El Sabbagh A.","year":"2018","journal-title":"Journal of the American College of Cardiology Cardiovasc Imaging"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.06.042"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2022-002180"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13503"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-11-200812020-00003"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2016.57"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf194"},{"key":"e_1_2_7_14_1","first-page":"678","article-title":"The Effect of Using a Remote Patient Management Platform in Optimizing Guideline\u2010Directed Medical Therapy in Heart Failure Patients: A Randomized Controlled Trial","volume":"12","author":"Brahmbhatt D. H.","year":"2024","journal-title":"Journal of the American College of Cardiology Heart Failure"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11897-024-00649-x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010024\u201003238\u20106"},{"key":"e_1_2_7_17_1","article-title":"Inclusive Health Tracking","volume":"2","author":"Schuuring M. J.","year":"2023","journal-title":"Journal of the American College of Cardiology Advances"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T12:41:36Z","timestamp":1767012096000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.70370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/echo.70370"],"URL":"https:\/\/doi.org\/10.1111\/echo.70370","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"type":"print","value":"0742-2822"},{"type":"electronic","value":"1540-8175"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-08-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70370"}}