fig3

Figure 3. Exercise-induced changes in MR severity during handgrip exercise (n = 93). Eighteen patients (78%) with moderate DMR at rest and 26 patients (84%) with moderate FMR at rest revealed exercise-induced increase in echocardiographic parameters representing dynamic severe MR. Note that only patients who underwent PMVR were included and not those who were not selected for PMVR due to remaining mild or moderate MR during exercise, making a selection bias probable. However, 10 patients with moderate MR at rest and during exercise underwent MitraClip implantation due to persistent severe symptoms. MR: mitral regurgitation; DMR: degenerative mitral regurgitation; FMR: functional mitral regurgitation