Angiotensin receptor blockers are associated with a lower remodelling score of stenotic aortic valves
Bibliographic record
Abstract
BACKGROUND: Experimental and clinical studies have suggested that inhibitors of the renin angiotensin system (RAS) might be useful to slow the progression of valvular calcification in patients with aortic stenosis (AS). OBJECTIVES: The aim of this study was to evaluate the relationships between the weight and tissue remodelling score of stenotic aortic valves explanted at the time of valve replacement surgery and to determine the effect of medications including angiotensin II receptor type I blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors on these variables. METHODS: Aortic valve and blood plasma were collected in 208 patients with AS (mean age: 69 ± 9) who underwent aortic valve replacement. Valves were weighed and the degree of valve tissue remodelling was assessed using a modified scoring system from Warren (Score: 1-4). Also, the 0-cresolphtalein complexone method was used to measure the amount of calcium within the valve cusps. RESULTS: The mean weight of aortic valves was higher in men than in women (2·83 ± 0·09 vs. 1·91 ± 0·09 g, P < 0·0001), in patients with bicuspid vs. tricuspid valves (3·21 ± 0·15 vs. 2·23 ± 0·07 g, P < 0·0001), and in patients with higher remodelling score (score 2: 1·86 ± 0·19 g; score 3: 2·08 ± 0·12 g; score 4: 3·08 ± 0·1 g, P < 0·0001). The remodelling score was higher in men (3·35 ± 0·05 vs. 2·94 ± 0·07, P < 0·0001) and in bicuspid valves (3·38 ± 0·07 vs. 3·14 ± 0·05, P = 0·006). Both valve weight (r = 0·44, P < 0·0001) and remodelling score (r = 0·23, P = 0·002) correlated with calcium content within the aortic valve. Patients under ARBs medication (n = 47, 22·6%) had lower aortic valve weights (2·14 ± 0·13 g vs. 2·63 ± 0·09 g, P = 0·001) and remodelling scores (3·01 ± 0·09 vs. 3·26 ± 0·04, P = 0·009). On multivariate analyses, ARBs were significantly associated with a lower aortic valve remodelling score (P = 0·04) and weight (P = 0·02). CONCLUSIONS: ARBs were associated with lower aortic valve weight and less pronounced tissue remodelling. Further studies are needed to determine if ARBs could be used as a therapeutic avenue in AS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".