What is mild trace mitral valve regurgitation (Mitral Regurgitation, MR)?

From the Guidelines

Mild trace mitral valve regurgitation is a harmless heart condition where a small amount of blood leaks backward through the mitral valve, typically not causing symptoms and not requiring treatment. This condition is characterized by a small, central jet of less than 4 cm2 or less than 20% of the left atrial area on color Doppler echocardiography, with a regurgitant volume of less than 30 ml per beat and a regurgitant fraction of less than 30% 1. The mitral valve separates the left atrium and left ventricle of the heart, and in mild regurgitation, the valve doesn't close completely, allowing a tiny amount of blood to flow back into the left atrium.

• Key characteristics of mild mitral regurgitation include:
  • Angiographic grade of 1
  • Color Doppler jet area of less than 4 cm2 or less than 20% of the left atrial area
  • Doppler vena contracta width of less than 0.3 cm
  • Regurgitant volume of less than 30 ml per beat
  • Regurgitant fraction of less than 30%
  • Regurgitant orifice area of less than 0.20 cm2 Regular follow-up with a doctor is recommended to monitor the condition, usually with occasional echocardiograms every few years to ensure it doesn't worsen 1. No medications are typically needed for mild cases, and maintaining heart health through regular exercise, healthy diet, and avoiding smoking is beneficial. This condition occurs because of slight structural abnormalities in the valve leaflets or supporting structures, but at the mild trace level, these abnormalities are minimal and don't affect heart function.

From the Research

Definition of Mild Trace Mitral Valve Regurgitation

Mild trace mitral valve regurgitation refers to a condition where the mitral valve does not close properly, allowing a small amount of blood to flow backward from the left ventricle into the left atrium. This condition is considered mild when the amount of regurgitant blood is minimal.

Characteristics of Mild Trace Mitral Valve Regurgitation

• The regurgitant fraction is typically less than 20-30% of the left ventricular stroke volume 2
• The regurgitant volume is usually small, less than 10-15 ml per beat 2
• The left ventricular ejection fraction is often normal or slightly reduced 3, 4
• The condition may be asymptomatic or associated with mild symptoms such as fatigue, shortness of breath, or palpitations

Treatment and Management

• ACE inhibitors and angiotensin receptor blockers (ARBs) may be used to reduce the regurgitant fraction and improve left ventricular function 3, 2
• Beta-blockers may also be used to reduce the regurgitant fraction and improve symptoms 4, 5
• Combination therapy with ACE inhibitors and beta-blockers may be effective in reducing the regurgitant fraction and improving cardiovascular outcomes 6

Prognosis and Outcomes

• Mild trace mitral valve regurgitation is generally associated with a good prognosis, especially if left ventricular function is preserved 3, 4
• However, the condition can progress over time, and regular monitoring is necessary to assess the severity of regurgitation and left ventricular function 2, 5