marker of poorer prognosis. It is important to assess mechanism contributing to MR, which should be further evaluated. Although medical therapy is the most common therapy offered, its impact on prognosis is far from satisfactory. Surgical interventions have superior outcomes as compared to medical therapy, either alone or with CRT. MV repair/MVR needs to be considered for patients with severe MR with LV dysfunction. Percutaneous approaches are promising but need more data.