Pulmonary hypertension: a long-term risk stratifier in primary mitral regurgitation

Primary MR is a degenerative disease whose rates are continuously increasing within the elderly population. It is a progressive disease in which chronic volume overloading causes myocardial damage, heart failure and even death; however, the correction of MR is curative (1). The ideal timing of surgical intervention in primary MR is critical but still challenging. The degree of dyspnoea, amount of regurgitant volume, signs of left ventricular (LV) decompensation, and complications of atrial fibrillation and PH are considered when deciding the timing of the intervention. PH is a negative prognostic factor in various heart diseases, including primary MR (2). With PH in primary MR, more severe dyspnoea, higher operation-related and long-term mortality and more frequent persistent PH after surgery are associated (3-6).