Myosin heavy chain (MHC) synthesis rate (K_s) and degradation rate (K_d) are shown for dogs with severe mitral regurgitation (MR) at 2 weeks (2W), 4 weeks (4W), and 3 months (3M) after initiation of the lesion expressed as a percent of the total pool (A) and as mg/day (B). Because left ventricular mass increased by 30% and no increase in K_s could be detected, a decrease in K_d is inferred. Reprinted with permission from Matsuo et al. (8).

Survival after mitral valve repair (MVP) is compared with that after mitral valve replacement (MVR) for propensity-matched groups. Patients undergoing MVP had better survival. MR = mitral regurgitation. Reprinted with permission from Jokinen et al. (30).

Ejection fraction before and after mitral valve surgery with preservation of the mitral valve apparatus (solid circles) is compared with ejection fraction before and after mitral valve surgery with removal or the apparatus (open squares). Reprinted with permission from Rozich et al. (33).

Survival of patients after surgery for MR with normal ejection fraction (EF) (left) and with reduced EF (right) are shown. Advanced New York Heart Association (NYHA) functional class had a large impact on survival in both groups. MR = mitral regurgitation; NS = nonsignificant. Reprinted with permission from Tribouilloy et al. (36).

Survival for patients with heart failure is shown for varying severities of MR. Patients with moderate to severe MR had a significantly worse outcome. CHF = congestive heart failure; MR = mitral regurgitation. Reprinted with permission from Trichon et al. (42).

Unadjusted (A) and propensity-adjusted (B) survival of patients with secondary MR are shown and separated into groups of coronary artery bypass graft (CABG) surgery alone or CABG surgery plus mitral annuloplasty. No difference in survival was detected. Reprinted with permission from Mihaljevic et al. (50). MV = mitral valve; other abbreviations as in Figure 5.