Baseline characteristics and outcomes of rheumatic mitral valve disease: the EURObservational Research Programme Valvular Heart Disease II Survey
Bibliographic record
Abstract
BACKGROUND AND AIMS: Rheumatic heart disease is the commonest acquired cardiovascular disease worldwide. About 20 years have elapsed since the original Euro Heart Survey on valvular heart disease (VHD) was conducted with multiple changes in practice due to advances in treatment techniques. In this study, we aimed to analyse the management of patients with severe native valve disease or those with previous valvular intervention in comparison with existing European Society of Cardiology guidelines. METHODS: The European Society of Cardiology VHD II registry is an international, prospective, longitudinal multicentre, observational study, which was conducted in 222 centres. The registry included patients with severe native VHD or with previous valvular intervention. Follow-up was undertaken at 6 months at the investigating centre or by telephone. RESULTS: Amongst patients recruited in the European Society of Cardiology VHD II registry, 470 had severe rheumatic mitral valve disease and 332 had previous rheumatic mitral valve intervention. Amongst the patients with Class I recommendation for intervention, it was undertaken in only 70%. Adherence to guideline recommendations was more in patients with native VHD than in those with previous intervention. Total mortality was 1.5% in hospital and 3.5% at 6 months follow-up. Independent predictors of death at 6 months were age, chronic pulmonary disease, New York Heart Association Classes III and IV at presentation, liver dysfunction, and previous myocardial infarction. CONCLUSIONS: Compliance with guideline recommendations for intervention is poor overall in patients with rheumatic valve disease. Concerted educational efforts are needed to improve the management of this vulnerable patient cohort.
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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 | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".