Another study by Boerlage-van Dijk et al. identified four key predictors of 2-year mortality in 84 high-risk patients with severe symptomatic MR: elevated baseline NT-proBNP (≥5000 μg/L), prior valve surgery, grade ≥ 3 tricuspid regurgitation, and failure to achieve significant MR reduction post-procedure. This evidence concerns the gene NPPB and miotic rate.