Trends in incidence and mortality from non-rheumatic degenerative mitral valve disease across europe, over the past three decades
Bibliographic record
Abstract
Abstract Background Valvular heart disease is common globally; mitral regurgitation is the most common valve pathology in the general population and subsequently the second most frequent indication for valve surgery in Europe. Whilst the European epidemiology of aortic stenosis is well elucidated in the literature, no Europe-wide study has been undertaken to identify trends in incidence and mortality secondary to non-rheumatic degenerative mitral valve disease. Purpose Our aim is to describe trends in degenerative mitral valve disease incidence and mortality throughout Europe from 1990 to 2019. Methods We performed a temporal analysis of data deposited in the Global Burden of Disease Study Database across the European Union. We extracted age-standardised incidence and age-standardised mortality rates for 20 member states from the database. We graphically inspected the data and performed Joinpoint regression analysis to detect and summarise periods of significant change. These periods were described using estimated annual percentage change (EAPC). Results Trends in age-standardised incidence and mortality rates were heterogenous amongst the 20 member states included. A gender disparity in mortality rates favouring males were present in Austria, Belgium, Greece, Hungary and the Netherlands throughout the time period studied. Except for Hungary, this disparity was not reflected in the incidence rates for the aforementioned countries. Incidence rates of degenerative mitral valve disease in 2019 were highest in Italy for both males and females with 90.6 and 140.1 cases per 100,000 respectively. Mortality rates in 2019 were highest in the Netherlands for both males in females with 1.7 and 2.0 cases per 100,000 respectively; this was preceded by a downwards trend in mortality with an EAPC of −7.3% and −8.5% respectively. Other notable inflection points in incidence trends were observed in Italy, with an EAPC of −4.9% females between 1994 to 2004 followed by an EAPC of 0.8% between 2009 to 2019. Conclusion No overall trends in non-rheumatic mitral valve disease were observed throughout Europe, but gender disparities and some notable deviations in incidence and mortality rates from the European median were identified. Overall, however, incidence rates remained static in most countries studied despite the ubiquity of colour flow doppler echocardiography. Further analysis of the burden of mitral valve disease can help elucidate this geographical variation. Funding Acknowledgement Type of funding sources: None.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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".