{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:30:10Z","timestamp":1778574610910,"version":"3.51.4"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although US recent data suggest that mitral regurgitation (MR) is severely undertreated and carries a poor outcome, population\u2010based views on outcome and management are limited. We aimed to define the current treatment standards, clinical outcomes, and costs related to MR at the nationwide level.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">In total, 107\u00a0412 patients with MR were admitted in France in 2014 to 2015. Within 1\u00a0year, 8% were operated and 92% were conservatively managed and constituted our study population (68% primary MR and 32% secondary MR). The mean age was 77\u00b115\u00a0years; most patients presented with comorbidities. In\u2010hospital and 1\u2010year mortality rates were 4.1% and 14.3%, respectively. Readmissions were common (63% at least once and 37% readmitted \u22652 times). Rates of 1\u2010year mortality or all\u2010cause readmission and 1\u2010year mortality or heart failure readmission were 67% and 34%, respectively, and increased with age, Charlson index, heart failure at admission, and secondary MR etiology; however, the event rate remained notably high in the primary MR subset (64% and 28%, respectively). The mean costs of hospital admissions and of readmissions were 5345\u00b16432 and 10\u00a0080\u00b110\u00a0847 euros, respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">At the nationwide level, MR was a common reason for admission and affected an elderly population with frequent comorbidities. Less than 10% of patients underwent a valve intervention. All subsets of patients who were conservatively managed incurred high mortality and readmissions rates, and MR represented a major societal burden with an extrapolated annual cost of 350 to 550 million euros (390\u2013615 million US dollars). New strategies to improve the management and outcomes of patients with both primary and secondary MR are critical and warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016086","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T09:20:56Z","timestamp":1595409656000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Dismal Outcomes and High Societal Burden of Mitral Valve Regurgitation in France in the Recent Era: A Nationwide Perspective"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6278-5670","authenticated-orcid":false,"given":"David","family":"Messika\u2010Zeitoun","sequence":"first","affiliation":[{"name":"University of Ottawa Heart Institute Ottawa Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Candolfi","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences Nyon Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alec","family":"Vahanian","sequence":"additional","affiliation":[{"name":"Department of Cardiology Assistance Publique \u2013 H\u00f4pitaux de ParisBichat Hospital Paris France"},{"name":"INSERM U1148 Bichat Hospital Paris France"},{"name":"University Paris VIIFacult\u00e9 de M\u00e9decine Paris\u2010Diderot Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Chan","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute Ottawa Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian G.","family":"Burwash","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute Ottawa Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Fran\u00e7ois","family":"Philippon","sequence":"additional","affiliation":[{"name":"Ecole des hautes \u00e9tudes en sant\u00e9 publique D\u00e9partement d\u2019\u00e9pid\u00e9miologie et de biostatistiques Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Manuel","family":"Toussaint","sequence":"additional","affiliation":[{"name":"International Health Market Trends Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Verta","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences Irvine CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ted E.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Edwards Lifesciences Irvine CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9127-348X","authenticated-orcid":false,"given":"Bernard","family":"Iung","sequence":"additional","affiliation":[{"name":"Department of Cardiology Assistance Publique \u2013 H\u00f4pitaux de ParisBichat Hospital Paris France"},{"name":"INSERM U1148 Bichat Hospital Paris France"},{"name":"University Paris VIIFacult\u00e9 de M\u00e9decine Paris\u2010Diderot Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Glineur","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute Ottawa Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Mesana","sequence":"additional","affiliation":[{"name":"University of Ottawa Heart Institute Ottawa Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurice","family":"Enriquez\u2010Sarano","sequence":"additional","affiliation":[{"name":"Mayo ClinicDivision of Cardiovascular DiseaseMayo Medical School Rochester MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69208-8"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw229"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy424"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.01.079"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805374"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816885"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.12.054"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806640"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60692-9"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm001"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30473-2"},{"key":"e_1_3_1_14_2","unstructured":"PMSI . 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