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Transcatheter Tricuspid Valve Intervention in Patients With Right Ventricular Dysfunction or Pulmonary Hypertension

2021· article· en· W3127724646 on OpenAlexaff
Guillem Muntané‐Carol, Maurizio Taramasso, Mizuki Miura, Mara Gavazzoni, Alberto Pozzoli, Hannes Alessandrini, Azeem Latib, Adrian Attinger‐Toller, Luigi Biasco, Daniel Braun, Éric Brochet, Kim A. Connelly, Sabine de Bruijn, Paolo Denti, Florian Deuschl, Edith Lubos, Sebastian Ludwig, Daniel Kalbacher, Rodrigo Estévez‐Loureiro, Neil Fam, Christian Frerker, Edwin Ho, Jean‐Michel Juliard, Ryan Kaple, Susheel Kodali, Felix Kreidel, Claudia Harr, Alexander Lauten, Julia Lurz, Vanessa Moñivas, Michael Mehr, Tamin Nazif, Georg Nickening, Giovanni Pedrazzini, François Philippon, Fabien Praz, Rishi Puri, Ulrich Schäfer, Joachim Schöfer, Horst Sievert, Gilbert H.L. Tang, Ahmed A. Khattab, Martin Andreas, Marco Russo, Hölger Thiele, Matthias Unterhuber, Dominique Himbert, Marina Ureña, Ralph Stephan von Bardeleben, John G. Webb, Marcel Weber, Stephan Windecker, Mirjam Winkel, Michel Züber, Jörg Hausleiter, Philipp Lurz, Francesco Maisano, Martin B. Leon, Rebecca T. Hahn, Josep Rodés‐Cabau

Bibliographic record

VenueCirculation Cardiovascular Interventions · 2021
Typearticle
Languageen
FieldMedicine
TopicCardiac Valve Diseases and Treatments
Canadian institutionsSt. Michael's HospitalSt. Paul's Hospital
Fundersnot available
KeywordsPulmonary hypertensionMedicineCardiologyTricuspid valveInternal medicineRight heartIntervention (counseling)Right heart failureRight heart catheterization

Abstract

fetched live from OpenAlex

Background: Scarce data exist on patients with right ventricular dysfunction (RVD) or pulmonary hypertension (PH) undergoing transcatheter tricuspid valve intervention. This study aimed to determine the early and midterm outcomes and the factors associated with mortality in this group of patients. Methods: This subanalysis of the multicenter TriValve (Transcatheter Tricuspid Valve Therapies) registry included 300 patients with severe tricuspid regurgitation with RVD (n=244), PH (n=127), or both (n=71) undergoing transcatheter tricuspid valve intervention. RVD was defined as a tricuspid annular plane systolic excursion <17 mm, and PH as an estimated pulmonary artery systolic pressure ≥50 mm Hg. Results: Mean age of the patients was 77±9 years (54% women). Procedural success was 80.7%, and 9 patients (3%) died during the hospitalization. At a median follow-up of 6 (interquartile range, 2–12) months, 54 patients (18%) died, and the independent associated factors were higher gamma-glutamyl transferase values at baseline (hazard ratio, 1.02 for each increase of 10 u/L [95% CI, 1.002–1.04]), poorer renal function defined as an estimated glomerular filtration rate <45 mL/min (hazard ratio, 2.3 [95% CI, 1.22–4.33]), and the lack of procedural success (hazard ratio, 2.11 [95% CI, 1.17–3.81]). The grade of RVD and the amount of PH at baseline were not found to be predictors of mortality. Most patients alive at follow-up improved their functional class (New York Heart Association I–II in 66% versus 7% at baseline, P <0.001). Conclusions: In patients with severe tricuspid regurgitation and RVD/PH, transcatheter tricuspid valve intervention was associated with high procedural success and a relatively low in-hospital mortality, along with significant improvements in functional status. However, about 1 out of 5 patients died after a median follow-up of 6 months, with hepatic congestion, renal dysfunction, and the lack of procedural success determining an increased risk. These results may improve the clinical evaluation of transcatheter tricuspid valve intervention candidates and would suggest a closer follow-up in those at increased risk. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03416166.

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 imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.002
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.001
Threshold uncertainty score0.004

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.019
GPT teacher head0.270
Teacher spread0.252 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations44
Published2021
Admission routes1
Has abstractyes

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