Natural History of Functional Tricuspid Regurgitation after Device Closure of Atrial Septal Defect
Bibliographic record
Abstract
Functional tricuspid regurgitation (TR) is a significant complication in patients diagnosed with atrial septal defect (ASD) and occurs due to right-heart volume overload from the left to right shunting of blood at the atrial level. A reduction in the severity of TR after ASD closure has been reported, however, the frequency, timing and magnitude of TR reduction after ASD device closure has not been well established. Moreover, the factors which may affect the TR severity after ASD closure are poorly understood. An improved understanding of these parameters has important implications for the management of patients being considered for ASD device closure. In the present prospective longitudinal cohort study, I aim to examine the chronological change in TR severity after transcatheter ASD device closure and to determine predictors of moderate to severe TR persistence. The present study included a total of 84 patients who underwent successful transcatheter ASD device closure at St Michael’s Hospital (Toronto, Canada) between 2007 and 2018 and who underwent serial clinical and echocardiographic follow-up up to nine years (mean follow up = 1095 days). The mean age of the study cohort was 48±15 years (32% male). The results showed that the prevalence of moderate to severe TR reduced from 31% at baseline to 13% at day 7, 12% at 2 months and 6% at 6 months. This reduction in TR was associated with similar reduction in dimensions of both right atrium and right ventricle. The univariate predictors of persistent moderate to severe TR after ASD closure included female gender (p=0.034), history of hypertension (p=0.033), elevated RVSP (p<0.001) and moderate to severe TR (p<0.001) at baseline. The multivariate predictors of persistent moderate to severe TR during follow up included elevated RVSP (p=0.009) and moderate to severe TR at baseline (p=0.044). These findings indicate that patients diagnosed with ASD should be considered for ASD device closure before development of moderate to severe TR or elevation of pulmonary artery pressures to achieve optimum reduction in post procedural TR.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| 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".