Mitral regurgitation management : a systematic review of clinical practice guidelines and recommendations
(2022) In European heart journal. Quality of care & clinical outcomes 8(5). p.481-495- Abstract
Multiple guidelines exist for the diagnosis and management of mitral regurgitation (MR), the second most common valvular heart disease in high-income countries, with recommendations that do not always match. We systematically reviewed guidelines on diagnosis and management of MR, highlighting similarities and differences to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (1 June 2010 to 1 September 2021), the Guidelines International Network, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations. Two reviewers independently screened the abstracts and... (More)
Multiple guidelines exist for the diagnosis and management of mitral regurgitation (MR), the second most common valvular heart disease in high-income countries, with recommendations that do not always match. We systematically reviewed guidelines on diagnosis and management of MR, highlighting similarities and differences to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (1 June 2010 to 1 September 2021), the Guidelines International Network, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations. Two reviewers independently screened the abstracts and identified articles of interest. Guidelines that were rigorously developed (as assessed with the Appraisal of Guidelines for Research and Evaluation II instrument) were retained for analysis. Five guidelines were retained. There was consensus on a multidisciplinary approach from the heart team and for the definition and grading of severe primary MR. There was general agreement on the thresholds for intervention in symptomatic and asymptomatic primary MR; however, discrepancies were present. There was agreement on optimization of medical therapy in severe secondary MR and intervention in patients symptomatic despite optimal medical therapy, but no consensus on the choice of intervention (surgical repair/replacement vs. transcatheter approach). Cut-offs for high-risk intervention in MR, risk stratification of progressive MR, and guidance on mixed valvular disease were sparse.
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- author
- Galusko, Victor ; Sekar, Baskar ; Ricci, Fabrizio LU ; Wong, Kit ; Bhattacharyya, Sanjeev ; Mullen, Michael ; Gallina, Sabina ; Ionescu, Adrian and Khanji, Mohammed Yunus
- organization
- publishing date
- 2022-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Guidelines, Mitral regurgitation, Mitral valve, Systematic review, Valvular heart disease
- in
- European heart journal. Quality of care & clinical outcomes
- volume
- 8
- issue
- 5
- pages
- 15 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85136908862
- pmid:34878118
- ISSN
- 2058-1742
- DOI
- 10.1093/ehjqcco/qcab082
- language
- English
- LU publication?
- yes
- id
- 30390198-bcf8-4a7e-8c1c-746652b739b1
- date added to LUP
- 2022-10-25 15:22:17
- date last changed
- 2024-06-13 13:41:42
@article{30390198-bcf8-4a7e-8c1c-746652b739b1,
abstract = {{<p>Multiple guidelines exist for the diagnosis and management of mitral regurgitation (MR), the second most common valvular heart disease in high-income countries, with recommendations that do not always match. We systematically reviewed guidelines on diagnosis and management of MR, highlighting similarities and differences to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (1 June 2010 to 1 September 2021), the Guidelines International Network, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations. Two reviewers independently screened the abstracts and identified articles of interest. Guidelines that were rigorously developed (as assessed with the Appraisal of Guidelines for Research and Evaluation II instrument) were retained for analysis. Five guidelines were retained. There was consensus on a multidisciplinary approach from the heart team and for the definition and grading of severe primary MR. There was general agreement on the thresholds for intervention in symptomatic and asymptomatic primary MR; however, discrepancies were present. There was agreement on optimization of medical therapy in severe secondary MR and intervention in patients symptomatic despite optimal medical therapy, but no consensus on the choice of intervention (surgical repair/replacement vs. transcatheter approach). Cut-offs for high-risk intervention in MR, risk stratification of progressive MR, and guidance on mixed valvular disease were sparse.</p>}},
author = {{Galusko, Victor and Sekar, Baskar and Ricci, Fabrizio and Wong, Kit and Bhattacharyya, Sanjeev and Mullen, Michael and Gallina, Sabina and Ionescu, Adrian and Khanji, Mohammed Yunus}},
issn = {{2058-1742}},
keywords = {{Guidelines; Mitral regurgitation; Mitral valve; Systematic review; Valvular heart disease}},
language = {{eng}},
number = {{5}},
pages = {{481--495}},
publisher = {{Oxford University Press}},
series = {{European heart journal. Quality of care & clinical outcomes}},
title = {{Mitral regurgitation management : a systematic review of clinical practice guidelines and recommendations}},
url = {{http://dx.doi.org/10.1093/ehjqcco/qcab082}},
doi = {{10.1093/ehjqcco/qcab082}},
volume = {{8}},
year = {{2022}},
}