Treatment of Functional Mitral Regurgitation in Heart Failure

12Purpose of Review: To analyze the current state of the art of functional mitral regurgitation (FMR) treatment. Recent Findings: The first-line treatment of severe FMR consists of guideline medical therapy (GMT) and resynchronization therapy when indicated; the impact of new medical therapies like sacubitril/valsartan needs further assessment. Valvular intervention may be considered in FMR symptomatic patients despite GMT, and can be performed surgically or percutaneously. MitraClip is a safe percutaneous procedure associated with symptoms improvement. Recently, the COAPT trial showed superior outcomes for MitraClip versus GMT contrasting the MITRA-FR trial which showed no benefit of MitraClip compared with GMT. These results should be interpreted as complementary rather than opposite. Summary: The COAPT trial provided a “proof of concept” that percutaneous treatment of severe FMR in patients without too advanced left ventricular disease translates into a prognostic benefit. Careful patient selection will play a critical role in defining the clinical niche for successful interventions.reservedmixedFabris E.; De Luca A.; Vitrella G.; Stolfo D.; Mase M.; Korcova R.; Merlo M.; Rakar S.; van't Hof A.W.J.; Kedhi E.; Perkan A.; Sinagra G.Fabris, E.; De Luca, A.; Vitrella, G.; Stolfo, D.; Mase, M.; Korcova, R.; Merlo, M.; Rakar, S.; van't Hof, A. W. J.; Kedhi, E.; Perkan, A.; Sinagra, G