Late referrals and high mortality in tricuspid regurgitation: a call for timely intervention
Why this work is in the frame
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Bibliographic record
Abstract
Abstract Aims Tricuspid regurgitation (TR) is associated with increased morbidity and mortality. The optimal timing for referral and intervention remains uncertain. To evaluate outcomes in patients with TR referred for tricuspid valve intervention. Methods and results Fifty-eight consecutive patients were referred from May 2018 to April 2023. Patients were stratified into two groups: Group 1 who underwent either tricuspid valve transcatheter edge-to-edge repair (T-TEER) or transcatheter tricuspid valve replacement (TTVR); Group 2 who died without intervention due to: awaiting candidacy assessment; awaiting intervention; deemed unsuitable for intervention. Key endpoints: in-patient, 30-day, 12- and 18-month mortality; new pacemaker implantation; echocardiographic TR grading; improvement in NYHA functional class; and heart failure-related readmissions at 30 days and 12 months. Among 58 patients, 43 underwent intervention (TTVR, n = 29; T-TEER, n = 14), 15 died without intervention (awaiting assessment n = 11; awaiting procedure n = 1, unsuitable n = 3). At the time of referral, the mean age was 77.0 ± 9.8 years, and 52 patients (90%) were diagnosed with functional TR; 30-day mortality in Group 1 was 12%, and 12-month mortality reached 33%, with heart failure readmission (37%); 12-month mortality in Group 2 was 73%. At 18 months, mortality reached 37% in Group 1 and 100% in Group 2. Baseline characteristics differed significantly between the groups for body mass index, severity of TR (massive or torrential), NYHA III–IV symptoms, and validated mortality scores. Conclusion Referrals for TR often occur after substantial comorbidities have developed resulting in high mortality but should be considered for a referral and intervention at an earlier stage.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 it