Abstract 16308: Comparison of Myocardial Mechanics Post Mitral Valve Repair With Leaflet Preservation vs. Leaflet Resection: A Sub-Analysis of the Randomized CAMRA CardioLink-2 Trial
Bibliographic record
Abstract
Introduction: Prior studies comparing leaflet resection vs. leaflet preservation for surgical repair of mitral regurgitation (MR) caused by prolapse focus predominantly on measurement of left ventricular ejection fraction. This study aims to evaluate subclinical differences in myocardial mechanics pre- mitral valve (MV) repair, immediately after, and 1-year post-repair, as well as compare differences between leaflet resection and preservation strategies. Methods: 104 patients were randomly assigned to the resection or preservation group for surgical treatment of posterior leaflet prolapse in the Canadian Mitral Research Alliance CardioLink-2 study. Speckle-tracking echocardiography was performed at baseline (pre-repair), immediately post-repair, and 1 year post-repair. Global longitudinal strain (GLS) was compared at the three timepoints, as well as between leaflet preservation and resection groups using descriptive statistics. Results: The mean age of the participants was 65 ± 10 years, and 83% were male. The mean GLS pre-MV repair was -19.6 ± 5.4, and did not differ between the leaflet resection and leaflet preservation groups. The mean GLS dropped to -12.8 ± 4.7 immediately post-repair (p= 0.001 compared to pre-repair). The GLS immediately post-repair was slightly lower in the leaflet resection vs. preservation group (-11.8 ± 4.9 vs. -14.2 ± 3.3, p=0.04). At 1 year post-repair, the mean GLS improved to -16 ± 4, but remained below pre-repair values (p=0.001 compared to immediate post-repair, p=0.03 compared to pre-repair values). At 1-year follow-up, there were no differences in GLS between the leaflet resection and preservation groups. Conclusion: The leaflet preservation and resection techniques for surgical repair of MR have similar effects on myocardial mechanics 1-year post-repair. MV repair is associated with an immediate reduction in myocardial strain, with only partial recovery in the first year post-MV repair. Further studies are needed to determine whether myocardial strain continues to improve beyond the first year post-repair to baseline levels.
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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 | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".