Severity of mitral valve prolapse is associated with basal left ventricular hypertrophy: a cardiac magnetic resonance study
Bibliographic record
Abstract
Recently, basal left ventricular hypertrophy has been suggested as a new form of hypertrophic cardiomyopathy. However, we have noticed that substantial focal basal hypertrophy often occurs in patients with mitral valve prolapse (Figure 1 ). Focal basal lateral wall hypertrophy in a patient with mitral valve prolapse. Our objective was to characterize the extent and distribution of focal basal left ventricular hypertrophy in patients with MVP and assess the correlation between the degree of focal hypertrophy and various myocardial structural parameters. Sixty-two patients (mean age: 58 years +/- 14; 56% males) with MVP and 20 age-matched normal volunteers (mean age: 53 years +/- 11; 50% males) were assessed using cardiac magnetic resonance imaging. We compared the ratio of basal to mid end-diastolic wall thickness in both groups and correlated it with various parameters such as age, left ventricular dimensions, degree of prolapse, mitral regurgitation volume, and mitral annular excursion. Fourty-three (70%) patients had posterior leaflet prolapse, 2 (3%) patients had anterior leaflet prolapse and 17 (27%) patients had bileaflet prolapse. There was a significantly increased ratio of basal to mid end-diastolic wall thickness in all segments of the left ventricle in MVP patients when compared to controls (Figure 2 ). The inferolateral (2.1 vs. 1.0, p<0.01) and anterolateral ratios (2.1 vs. 1.1, p<0.01) were the highest compared to the other myocardial segments. Similar results were found when we analyzed the bileaflet and posterior leaflet prolapse patients separately. The degree of mitral annular excursion had a moderate linear correlation with the degree of hypertrophy (r2=0.72). However, age (r2=0.01), left ventricular end diastolic volume index (r2=0.01), left ventricular end systolic volume index (r2=0.01), degree of prolapse (r2=0.05), and mitral regurgitation volume (r2=0.02) did not have any significant correlation with the degree of hypertrophy. Relative basal left ventricular hypertrophy in patients with mitral valve prolapse. MVP is associated with concentric basal hypertrophy of the left ventricle. A moderate correlation between the excursion of the mitral valve annulus and the degree of relative hypertrophy suggests the possibility that locally increased myocardial function may be responsible for the hypertrophy. It is important to consider this mechanism when evaluating patients with basal hypertrophy to exclude the incorrect diagnosis of hypertrophic cardiomyopathy.
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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 | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".