Renal function improvement correlates with 3D echocardiographic findings: Effect of surgical mitral valve repair

J Clin Ultrasound. 2024 May;52(4):385-393. doi: 10.1002/jcu.23646. Epub 2024 Feb 12.

Abstract

Background: The association between surgical treatment of mitral regurgitation (MR) and renal function is not sufficiently well-known. We tried to evaluate renal function before and after the procedure of surgical mitral valve repair (SMVR) in degenerative severe MR.

Methods: Patients with primary severe (4+) MR and normal left ventricular ejection fraction (LVEF) that underwent SMVR, examined by a cutting-edge 3-dimensional (3D) echocardiographic probe were enrolled in this study. We took three CKD-EPI equations to measure estimated glomerular filtration rate (eGFR) before SMVR and shortly before patients discharge. A total of 40 patients with baseline lower mean eGFR were evaluated.

Results: Measurements substantiated statistically significant improvements in eGFR (p < 0.001), multivariable linear regression modeling indicating prominent associations between increase in eGFR and decrease of MR (p = 0.003), decline of pulmonary arterial systolic pressure (p = 0.018), as well as increment of forward stroke volume (p = 0.02), in spite of LVEF reduction, left ventricular global longitudinal strain worsening and left atrial ejection fraction impairment.

Conclusions: Renal function improves after SMVR in patients with degenerative significant MR and preserved LVEF, regardless of cardiac functional worsening.

Keywords: 3D echocardiography; mitral regurgitation; renal function; surgical mitral valve repair.

MeSH terms

  • Aged
  • Echocardiography, Three-Dimensional* / methods
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney / diagnostic imaging
  • Kidney / physiopathology
  • Kidney / surgery
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency* / diagnostic imaging
  • Mitral Valve Insufficiency* / physiopathology
  • Mitral Valve Insufficiency* / surgery
  • Mitral Valve* / diagnostic imaging
  • Mitral Valve* / physiopathology
  • Mitral Valve* / surgery
  • Stroke Volume / physiology
  • Treatment Outcome