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Mitral regurgitation (MR) is one of the most challenging valvular heart diseases (VHDs) to diagnose and manage. It is thus extremely important and useful for the medical community to have high-quality and well-disseminated guidelines. However, this exercise may become futile if we do not know whether the physicians are aware of these guidelines and apply them in real-life clinical practice. In this issue of the journal, Iung et al. reported the results of an elegant study in which they performed a mixed-methods educational needs assessment. An online survey was undertaken using three case scenarios (asymptomatic severe primary MR, symptomatic severe primary MR in the elderly, and severe secondary MR) with 115 primary care physicians (PCPs) and 439 cardiologists or cardiac surgeons from seven European countries. The important good news of this survey was that ESC guidelines are widely used by European cardiologists. However, it also revealed some bad news and need for improvement.

european heart journal

Knowledge and application of European Society of Cardiology (ESC) Guidelines in the management of mitral regurgitation: this is not bad but we can do much better