Epidemiology, pathophysiology, diagnosis and management of atrial functional mitral regurgitation: An expert opinion paper

Atrial functional mitral regurgitation (AFMR) is an increasingly recognized subtype of mitral regurgitation, characterized by left atrial remodelling and mitral annular dilation in the absence of primary mitral valve disease or left ventricular dysfunction. Closely linked to chronic atrial fibrillation and heart failure with preserved ejection fraction, AFMR is associated with poor clinical outcomes and represents a growing therapeutic challenge. This expert opinion paper summarizes current evidence on the epidemiology, pathophysiology, diagnosis and management strategies, including medical therapy and emerging data supporting surgical and transcatheter interventions in selected patients. However, data from prospective controlled clinical trials are still lacking. Future research is needed to refine patient selection, long-term outcomes and to support evidence-based recommendations for this increasingly prevalent condition.