Asch FM, Grayburn PA, Siegel RJ, et al. - Given reduced rates of heart failure (HF) hospitalization and mortality in patients managed with transcatheter mitral valve repair (TMVr) through leaflet approximation vs guideline-directed medical therapy alone have been reported among patients with HF and moderate-to-severe (3+) or severe (4+) secondary mitral regurgitation in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial, researchers define the echocardiographic patient qualification process for the COAPT trial, baseline echocardiographic features, alterations over time, as well as the interaction between treatment group and echocardiographic parameters on clinical outcomes. Findings revealed the benefits of TMVr with decreased 2-year rates of death and HF hospitalization among HF patients in the COAPT trial with 3+ or 4+ secondary mitral regurgitation, picked using strict echocardiographic criteria. The translation of the COAPT results to clinical practice should be allowed by the strict application of these echocardiographic criteria.