Determinants of postoperative left ventricle dysfunction in patients with chronic asymptomatic severe mitral regurgitation due to myxomatous degeneration
Bibliographic record
Abstract
Purpose: The evidence supporting early surgical intervention in patients with chronic asymptomatic mitral regurgitation (MR) is steadily accumulating. Although preoperative pulmonary hypertension and left ventricular (LV) enlargement are considered when deciding on surgery, the threshold above which they influence clinical outcomes remain poorly defined. Methods: One-hundred sixty eight asymptomatic patients of mean age 60.9±12.9 years underwent mitral valve repair of severe MR due to myxomatous degeneration between 2001 and 2012. Mean preoperative left atrial diameter, LV end-systolic diameter, and right ventricular systolic pressure were 48.2±7.6 mm, 34.7±7.4 mm, and 38.4±10.6 mm Hg, respectively. Preoperative LV ejection fraction was >60% in 137 (82%) and 24 (14%) had preoperative atrial fibrillation. Clinical and echocardiographic follow-up averaged 3.3 years, and extended to 9.1 years. Results: There were no perioperative deaths. Five-year survival and freedom from recurrent MR ≥2+ were 93.1±3.4% and 94.2±2.2%, respectively. A threshold preoperative right ventricular systolic pressure >45 mm Hg and (hazard ratio, HR, 3.55±1.65,p=0.007) and LV end-systolic pressure indexed to body surface area >19 mm/m2 (HR 3.63±1.99, p=0.02) were associated with postoperative LV dysfunction, defined as a LV ejection fraction <60%. Conclusion: Mitral valve repair can be performed with favorable early and late outcomes in patients with asymptomatic severe MR. The presence of preoperative pulmonary hypertension and minimal LV enlargement were associated with postoperative LV dysfunction in this otherwise healthy population. Mitral valve repair should be considered in asymptomatic patients with a preoperative right ventricular systolic pressure >45 mm Hg or an indexed LV end-systolic diameter >19mm/m2.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".