Medical Therapy for Functional Mitral Regurgitation

Assi Milwidsky, Sheetal Vasundara Mathai, Yan Topilsky, Ulrich P. Jorde

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Functional mitral regurgitation (FMR) can be broadly categorized into 2 main groups: ventricular and atrial, which often coexist. The former is secondary to left ventricular remodeling usually in the setting of heart failure with reduced ejection fraction or less frequently due to ischemic papillary muscle remodeling. Atrial FMR develops due to atrial and annular dilatation related to atrial fibrillation/flutter or from increased atrial pressures in the setting of heart failure with preserved ejection fraction. Guideline-directed medical therapy is the first step and prevails as the mainstay in the treatment of FMR. In this review, we address the medical therapeutic options for FMR management and highlight a targeted approach for each FMR category. We further address important clinical and echocardiographic characteristics to aid in determining when medical therapy is expected to have a low yield and an appropriate window for effective interventional approaches exists.

Original languageEnglish (US)
Pages (from-to)E009689
JournalCirculation: Heart Failure
Issue number9
StatePublished - Sep 1 2022


  • atrial fibrillation
  • mitral valve insufficiency
  • papillary muscles
  • stroke volume
  • ventricular remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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