Evaluation of three-dimensional right ventricular function and reverse remodelling in patients undergoing percutaneous mitral valve repair for functional mitral regurgitation: insights from a multicentre Italian registry
Bibliographic record
Abstract
Background The predictive role of right ventricular dysfunction (RVD) in patients with functional mitral regurgitation (FMR) undergoing transcatheter edge-to-edge repair (TEER), as well as RV remodelling following the procedure, remains uncertain. We evaluated the prognostic impact of pre-procedural three-dimensional (3D) right ventricular ejection fraction (RVEF) in patients with FMR. Additionally, we assessed the RV reverse remodelling (RVRR) based on 3D volumes and ejection fraction six months after the procedure.Methods Data from 74 patients treated with TEER for FMR were prospectively collected. Pre-procedural RVD, defined as 3D RVEF ≤45%, was observed in 47 patients (63.5%). Patients were divided into three groups according to pre-procedural 3D-RVEF: no RVD (No-RVD, RVEF >45%, n = 27), mild-to-moderate RVD (MRVD, RVEF 31-45%, n = 36), and severe RVD (SRVD, RVEF ≤30%, n = 11).Results Patients with SRVD demonstrated a significant higher rate of all-cause mortality compared with the other two groups (p = 0.04) and RVEF ≤ 30% was associated with all-cause death, independently of left ventricular ejection fraction (LVEF) and left atrial volume index (LAVi) (HR: 3.72, 95% CI 1.12–12.30, p = 0.03). At 6-month follow-up, only patients with pre-procedural MRVD showed a significant reduction in 3D RV volumes and an improvement in RVEF compared to baseline (p < 0.05).Conclusions RVD was common among patients undergoing mitral TEER for FMR. Those with pre-procedural SRVD had worse mid-term survival compared to patients with MRVD and No-RVD. The group with MRVD was the only one to demonstrate an RVRR six months after the procedure.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.002 |
| 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 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".