# Improving Phenotypic Classification and Prediction of Treatment Outcomes in Patients with Non-ischemic Cardiomyopathy and Functional Mitral Regurgitation

> **NIH NIH R01** · CLEVELAND CLINIC LERNER COM-CWRU · 2024 · $793,920

## Abstract

Project Summary
 Functional mitral regurgitation (FMR) portends a bleak prognosis and is a common
consequence of ischemic and non-ischemic cardiomyopathy (ICM, NICM), where adverse
annular and left ventricular (LV) remodeling and/or infarction alters mitral valve (MV) function.
Prior studies demonstrate significant increases in mortality risk as severity of FMR increases;
mortality rates range from 15-40% at 1 year. Furthermore, as the prevalence of heart failure
(HF) is rising, FMR is projected to double from over 2 million patients in 2000 to over 4 million
patients in the United States by 2030. Defining FMR severity, optimal timing of intervention, and
most appropriate method for intervention remain controversial. Recently, MITRA-FR and
COAPT trials demonstrated contrasting survival benefit with percutaneous MV repair,
demonstrating the importance and need for more optimal selection criteria. Currently, the patient
selection criteria for Mitraclip therapy are solely based on MV anatomy and controversial
echocardiographic criteria for FMR severity. Cardiac magnetic resonance (CMR) provides an
exciting opportunity to address numerous unmet needs regarding characterizing FMR and the need
for more optimal selection criteria for improving outcomes. Superior accuracy and reproducibility for
quantification of LV size and function, and gold standard tissue characterization, positions CMR as
the ideal imaging modality for comprehensively characterizing FMR and the underlying myopathic
processes that significantly impact response to FMR therapies. The goal of the current research is
to develop personalized risk prediction for FMR patients through explainable unsupervised
phenomapping enriched with advanced CMR imaging biomarkers, and to determine the CMR
predictors of reverse remodeling following modern therapies for FMR.

## Key facts

- **NIH application ID:** 10885203
- **Project number:** 5R01HL170090-02
- **Recipient organization:** CLEVELAND CLINIC LERNER COM-CWRU
- **Principal Investigator:** DEBORAH KWON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $793,920
- **Award type:** 5
- **Project period:** 2023-07-10 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10885203

## Citation

> US National Institutes of Health, RePORTER application 10885203, Improving Phenotypic Classification and Prediction of Treatment Outcomes in Patients with Non-ischemic Cardiomyopathy and Functional Mitral Regurgitation (5R01HL170090-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10885203. Licensed CC0.

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