The impact of pulmonary hypertension on prognosis in moderate-to-severe mitral regurgitation patients treated with transcatheter edge-to-edge mitral valve repair: a comprehensive meta-analysis
Bibliographic record
Abstract
Objective This meta-analysis aims to assess the impact of pulmonary hypertension (PH) on the clinical prognosis of patients with moderate to severe mitral valve regurgitation (MR) undergoing transcatheter edge-to-edge mitral valve repair (TEER). Methods As of August 2024, relevant studies were identified through searches of the PubMed, Cochrane Library, Web of Science, and Embase databases. A comprehensive screening process was conducted, with quality assessment performed utilizing the Newcastle Ottawa Scale (NOS). Data analysis was carried out using Stata17.0 software, generating forest plots, funnel plots, Egger's test, and sensitivity analysis plots to analyze heterogeneity and publication bias. Odds ratios (OR) and standardized mean differences (SMD) were calculated for dichotomous and continuous variables, respectively, each presented with a 95% confidence interval (CI). Results A total of 10 studies involving 28,404 patients were included, with all articles achieving a NOS score of ≥7. The outcome indicators were as follows: 2-year all-cause mortality [OR = 2.06, 95%CI(1.49, 2.84), p < 0.01, I 2 = 79.9%]; heart failure rehospitalization rate [OR = 1.56, 95%CI(1.29,1.76), p < 0.01, I 2 = 41.7%]; 30-day all-cause mortality [OR = 2.10, 95%CI(1.78,2.47), p < 0.01, I 2 = 0%]; cardiogenic mortality [OR = 2.00, 95%CI (1.61,2.49), p < 0.01, I 2 = 0%]; and length of hospital stay [OR = 0.17, 95%CI(0.14,0.20), p < 0.01, I 2 = 0%]. All outcome indicators demonstrated that the PH group had significantly worse outcomes compared to the non-PH group. Subgroup analyses were performed on outcome indicators with notable heterogeneity, focusing on PH measurement methods, PH diagnostic criteria, and the severity of PH. The results indicated that most combined subgroup outcomes were consistent with the overall findings and showed significantly reduced heterogeneity. The sources of heterogeneity are likely attributed to the methods of PH measurement, diagnostic criteria for PH, and the severity of PH. Conclusion Within two years after undergoing transcatheter edge-to-edge repair (TEER), patients with MR and PH experiecne significantly higher rates of all-cause mortality, 30-day all-cause mortality, heart failure readmissions, cardiogenic mortality, and longer hospital stays compared to those without PH. Systematic Review Registration https://inplasy.com/ , identifier (INPLASY202480068).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.084 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".