Interaction between renal function and percutaneous edge-to-edge mitral valve repair using MitraClip

Area of Science:

• Cardiology
• Nephrology
• Medical Devices

Background:

• MitraClip (MC) is a key treatment for mitral regurgitation.
• Renal dysfunction is a known comorbidity in cardiovascular disease.
• The impact of renal function on MC outcomes requires further elucidation.

Purpose of the Study:

• To investigate the association between renal function and outcomes in patients undergoing MitraClip (MC) procedures.
• To clarify the prognostic significance of estimated glomerular filtration rate (eGFR) in this patient cohort.

Main Methods:

• A cohort of 206 patients undergoing MC was stratified by eGFR into normal, mild CKD, and severe CKD groups.
• N-terminal pro-B type natriuretic peptide (NT-pro BNP) levels and long-term survival rates were analyzed.
• Multivariable analysis was performed to adjust for covariates.

Main Results:

• NT-pro BNP levels increased as eGFR decreased.
• Long-term survival rates significantly decreased with declining eGFR.
• Severe chronic kidney disease (CKD) remained an independent predictor of mortality.
• Approximately 30% of patients showed improved renal function post-MC, associated with lower NT-pro BNP and better survival.

Conclusions:

• Renal dysfunction is prevalent in MC patients and adversely affects survival, correlating with elevated NT-pro BNP.
• MitraClip (MC) may lead to renal function improvement in a subset of patients, positively impacting prognosis.
• These findings underscore the critical interplay between renal function and MC treatment efficacy.