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Updated: Apr 15, 2026

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

Published on: May 19, 2020

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The Prognostic Significance of Functional Mitral Regurgitation in Patients with Cardiovascular-Kidney-Metabolic

Haodong Du1, Yangyang Chen1, Chunlu Huang1

  • 1Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.

Journal of Clinical Medicine
|April 14, 2026
PubMed

Insights

Functional mitral regurgitation (FMR) and atrial FMR significantly increase mortality risk in hemodialysis patients with cardiovascular-kidney-metabolic syndrome. Early detection and management of FMR are crucial for improving outcomes in this high-risk group.

Area of Science:

  • Cardiology
  • Nephrology
  • Metabolic Diseases
  • Medical Outcomes Research

Background:

  • Cardiovascular-kidney-metabolic (CKM) syndrome links cardiovascular disease with renal or metabolic issues.
  • The prognostic impact of functional mitral regurgitation (FMR) in CKM syndrome patients is not well-defined.
  • This study investigates the association between FMR and clinical outcomes in CKM syndrome.

Purpose of the Study:

  • To determine the independent impact of FMR on all-cause mortality in patients with CKM syndrome undergoing hemodialysis.
  • To assess the prognostic value of both functional mitral regurgitation (FMR) and atrial functional mitral regurgitation (AFMR) in this population.

Main Methods:

  • Retrospective cohort study of 1201 CKM syndrome patients on maintenance hemodialysis (Jan 2020 - Nov 2024).
  • Patients stratified by FMR/AFMR presence and severity: non-FMR/AFMR, mild FMR/AFMR, and moderate-to-severe FMR/AFMR.
  • All-cause mortality analyzed using Kaplan-Meier and multivariate Cox proportional hazard models.

Main Results:

  • FMR was prevalent in 79.68% of the CKM cohort and independently associated with increased all-cause mortality (HR 1.831).
  • Even mild FMR significantly elevated mortality risk (HR 1.699) compared to no FMR.
  • AFMR independently predicted mortality (HR 2.106), with moderate-to-severe AFMR showing a three-fold higher risk (HR 3.294).

Conclusions:

  • Both FMR and AFMR are independently linked to higher all-cause mortality in hemodialysis patients with CKM syndrome.
  • These findings highlight the importance of early detection and tailored management of mitral regurgitation in this high-risk group.
  • Addressing FMR/AFMR may improve clinical outcomes for patients with CKM syndrome.

Keywords:
atrial functional mitral regurgitationcardiovascular–kidney–metabolic syndromeend-stage renal diseasefunctional mitral regurgitationheart failure with preserved ejection fraction

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