20.500.12556/DiRROS-31277 Incremental prognostic value of regurgitant fraction in patients with ventricular secondary mitral regurgitation Objectives: Quantifying ventricular secondary mitral regurgitation (MR) remains challenging, and the prognostic value of echocardiographic parameters is uncertain. This study aimed to assess the concordance of parameters of MR severity and determine the added value of regurgitant fraction (RF) in predicting outcomes. Methods and results: We retrospectively analysed 186 patients with ventricular secondary MR who underwent echocardiography with MR assessment, evaluating effective regurgitant orifice area (EROA), regurgitant volume (RegVol) and RF. The primary endpoint was a composite of all-cause death or heart failure hospitalisation. Quantitative parameters of MR severity were frequently discordant. Using the guideline-recommended cut-offs for EROA (≥40 mm2), RegVol (≥60 mL) and RF (≥50%), severe MR was present in 5.4%, 3.3%, and 29.5% of patients, respectively. Both RF ≥ 50% and EROA ≥ 40 mm2 were independently associated with clinical outcomes in multivariable Cox models. Combining RF and EROA provided incremental prognostic value over either parameter alone (p < 0.05). Kaplan–Meier curves showed that patients with EROA < 40 mm2 and RF ≥ 50% had similar outcomes to those with EROA ≥ 40 mm2 (p = 0.055), whereas patients with both EROA < 40 mm2 and RF < 50% had significantly better outcomes (p = 0.002). Conclusions: Substantial discordance between quantitative parameters of severe MR was observed in ventricular secondary MR. RF is a strong, underutilised marker of MR severity, reflecting haemodynamic burden beyond EROA and RegVol. Patients with EROA < 40 mm2 and RF > 50% had outcomes comparable to those who met the guideline-based threshold for severe MR, defined as EROA ≥ 40 mm2. Our results demonstrate that routine RF assessment may enhance risk stratification and enable identification of a high-risk subgroup of patients with EROA < 40 mm2. mitral regurgitation quantification PISA method regurgitant fraction outcome true false true Angleški jezik Ni določen Neznano 2026-07-23 14:07:58 2026-07-23 14:07:59 2026-07-24 03:52:05 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 28. 5. 2026; str.1-16 iss. 10, [article no.] 3854 Vol. 15 Apr. 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 61 2077-0383 10.3390/jcm15103854 279612163 https://www.mdpi.com/2077-0383/15/10/3854 1 2699c12a-868f-11f1-812a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=48318 RAZ_Ambrozic_Jana_2026.pdf RAZ_Ambrozic_Jana_2026.pdf 1 8456A8C271FE8AE31E0371B7677A5DCA a121a361fa0a6aa9159aaa9c7e7bac613ec9ea7a4e41ab350fcb2f93a5574e27 408e4c25-868f-11f1-812a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=48319 Univerzitetni klinični center Ljubljana 0 0 0