According to an abstract of the March 3 article (352:875-883), the predictive power of the effective regurgitant orifice superseded all other qualitative and quantitative measures of regurgitation. People with a regurgitant orifice of more than 40 square millimeters had an adjusted risk ratio of 2.9 for death from any cause, 5.2 for death from cardiac causes and 5.7 for cardiac events compared with people with a regurgitant orifice of less than 20 square millimeters.

Valve repair surgery was associated with improved survival, according to the study, performed by the Division of Cardiovascular Diseases and Internal Medicine, the Division of Cardiac Surgery and the Section of Biostatistics at the Mayo Clinic in Rochester, Minn.

The study concludes that quantitative grading of mitral regurgitation is a powerful predictor of clinical outcomes and that patients with an effective regurgitant orifice of 40 square millimeters or more should be "promptly" considered for repair surgery.