All subgroups, particularly severe MR, incurred similar excess mortality with BNP activation.

Moderate-to- severe MR is an independent predictor of cardiac death and HF.

Patients were stratified into 4 groups: no VHD, moderate-to- severe MR, moderate-to-severe AS, and both moderate-to-severe MR and AS.

Severe MR was induced through inflation of a temporary inferior vena cava filter placed within the mitral valve.

Furthermore, LA strain and untwisting rate were progressively and significantly reduced from normal subjects to patients with severe MR.

This strongly suggests that A140V is a hot spot of mutation resulting in moderate to severe MR in males.

In HFrEF, severe MR is associated with impaired O 2 delivery due to CO redistribution to the pulmonary circulation.

The Euro Heart Survey showed that up to 50 % of patients with severe MR are today denied surgical treatment.

In addition, 40 normal subjects undergoing cMRI and 40 with moderate to severe MR were included as controls.

Methods: A total of 274 patients with moderate or severe MR underwent MVR between October 1, 1991, and September 30, 2000.