I'm currently working on a new patch to make Qt 4.3/GPL compile with msvc. As Trolltech now ships the source code of configure.exe, I can create a modified one which doesn't complain about the wrong QMAKESPEC anymore. This will allow us to enable MMX, 3NOW and SSE support (mingw seems not support this and therefore it is disabled then) which should improve the performance in some places. The modified executable also removes the need to patch qconfig.cpp/qconfig.h after the configure-run :)
Afaics Qt 4.3 will be the last version where I can create a patch for. I'll get a commercial license in the near future and therefore I'm not allowed to create a patch for the GPL-version anymore.