title: Influence of percutaneous mitral valve repair using the MitraClip® system on renal function in patients with severe mitral regurgitation.
abstract: BACKGROUND
  In patients with mitral regurgitation (MR), changes in cardiac stroke volume, and thus renal preload and afterload may affect kidney function. Percutaneous mitral valve repair (PMVR) with the MitraClip® system can be a therapeutic alternative to surgical valve repair. The influence of MitraClip® therapy on renal function and clinical outcome parameters is unknown.
  
  
  RESULTS
  Sixty patients with severe MR underwent PMVR using the MitraClip® system in an open-label observational study. Patients were stratified according to their renal function. All clips have been implanted successfully. Effective reduction of MR by 2-3 grades acutely improved KDOQI class. Lesser MR reduction (MR reduction of 0-1 grades) led to worsening of renal function in patients with pre-existing normal or mild (KDOQI 1-2) compared to severe (KDOQI 3-4) renal dysfunction. Reduction of MR was associated with improvement in Minnesota Living with Heart Failure Questionnaire (MLHFQ), NYHA-stadium, and 6-minute walk test.
  
  
  CONCLUSIONS
  Successful PMVR was associated with an improvement in renal function. The improvement in renal function was associated with the extent of MR reduction and pre-existing kidney dysfunction. Our data emphasize the relevance of PVMR to stabilize the cardiorenal axis in patients with severe MR.
authors: Division of Cardiology, Pulmonology and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Medical Faculty, Moorenstrasse 5, 40225, Düsseldorf, Germany.
authors: Tienush
authors: T
authors: Rassaf
authors: Jan
authors: J
authors: Balzer
authors: Christos
authors: C
authors: Rammos
authors: Tobias
authors: T
authors: Zeus
authors: Katharina
authors: K
authors: Hellhammer
authors: Silke
authors: S
authors: v Hall
authors: Rabea
authors: R
authors: Wagstaff
authors: Malte
authors: M
authors: Kelm
mesh_terms: D000368:Aged; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011184:Postoperative Period; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: chronic; mitral valve disease; percutaneous intervention; renal disease