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Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair

Background: Mitral valve regurgitation (MR) is the most common valvular heart disease and current variables associated with MR recurrence are still controversial. We aim to develop a machine learning-based prognostic model to predict causes of mitral valve (MV) repair failure and MR recurrence. Meth...

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Autores principales: Penso, Marco, Pepi, Mauro, Mantegazza, Valentina, Cefalù, Claudia, Muratori, Manuela, Fusini, Laura, Gripari, Paola, Ghulam Ali, Sarah, Caiani, Enrico G., Tamborini, Gloria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469985/
https://www.ncbi.nlm.nih.gov/pubmed/34562939
http://dx.doi.org/10.3390/bioengineering8090117
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author Penso, Marco
Pepi, Mauro
Mantegazza, Valentina
Cefalù, Claudia
Muratori, Manuela
Fusini, Laura
Gripari, Paola
Ghulam Ali, Sarah
Caiani, Enrico G.
Tamborini, Gloria
author_facet Penso, Marco
Pepi, Mauro
Mantegazza, Valentina
Cefalù, Claudia
Muratori, Manuela
Fusini, Laura
Gripari, Paola
Ghulam Ali, Sarah
Caiani, Enrico G.
Tamborini, Gloria
author_sort Penso, Marco
collection PubMed
description Background: Mitral valve regurgitation (MR) is the most common valvular heart disease and current variables associated with MR recurrence are still controversial. We aim to develop a machine learning-based prognostic model to predict causes of mitral valve (MV) repair failure and MR recurrence. Methods: 1000 patients who underwent MV repair at our institution between 2008 and 2018 were enrolled. Patients were followed longitudinally for up to three years. Clinical and echocardiographic data were included in the analysis. Endpoints were MV repair surgical failure with consequent MV replacement or moderate/severe MR (>2+) recurrence at one-month and moderate/severe MR recurrence after three years. Results: 817 patients (DS1) had an echocardiographic examination at one-month while 295 (DS2) also had one at three years. Data were randomly divided into training (DS1: n = 654; DS2: n = 206) and validation (DS1: n = 164; DS2 n = 89) cohorts. For intra-operative or early MV repair failure assessment, the best area under the curve (AUC) was 0.75 and the complexity of mitral valve prolapse was the main predictor. In predicting moderate/severe recurrent MR at three years, the best AUC was 0.92 and residual MR at six months was the most important predictor. Conclusions: Machine learning algorithms may improve prognosis after MV repair procedure, thus improving indications for correct candidate selection for MV surgical repair.
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spelling pubmed-84699852021-09-27 Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair Penso, Marco Pepi, Mauro Mantegazza, Valentina Cefalù, Claudia Muratori, Manuela Fusini, Laura Gripari, Paola Ghulam Ali, Sarah Caiani, Enrico G. Tamborini, Gloria Bioengineering (Basel) Article Background: Mitral valve regurgitation (MR) is the most common valvular heart disease and current variables associated with MR recurrence are still controversial. We aim to develop a machine learning-based prognostic model to predict causes of mitral valve (MV) repair failure and MR recurrence. Methods: 1000 patients who underwent MV repair at our institution between 2008 and 2018 were enrolled. Patients were followed longitudinally for up to three years. Clinical and echocardiographic data were included in the analysis. Endpoints were MV repair surgical failure with consequent MV replacement or moderate/severe MR (>2+) recurrence at one-month and moderate/severe MR recurrence after three years. Results: 817 patients (DS1) had an echocardiographic examination at one-month while 295 (DS2) also had one at three years. Data were randomly divided into training (DS1: n = 654; DS2: n = 206) and validation (DS1: n = 164; DS2 n = 89) cohorts. For intra-operative or early MV repair failure assessment, the best area under the curve (AUC) was 0.75 and the complexity of mitral valve prolapse was the main predictor. In predicting moderate/severe recurrent MR at three years, the best AUC was 0.92 and residual MR at six months was the most important predictor. Conclusions: Machine learning algorithms may improve prognosis after MV repair procedure, thus improving indications for correct candidate selection for MV surgical repair. MDPI 2021-08-25 /pmc/articles/PMC8469985/ /pubmed/34562939 http://dx.doi.org/10.3390/bioengineering8090117 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Penso, Marco
Pepi, Mauro
Mantegazza, Valentina
Cefalù, Claudia
Muratori, Manuela
Fusini, Laura
Gripari, Paola
Ghulam Ali, Sarah
Caiani, Enrico G.
Tamborini, Gloria
Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair
title Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair
title_full Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair
title_fullStr Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair
title_full_unstemmed Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair
title_short Machine Learning Prediction Models for Mitral Valve Repairability and Mitral Regurgitation Recurrence in Patients Undergoing Surgical Mitral Valve Repair
title_sort machine learning prediction models for mitral valve repairability and mitral regurgitation recurrence in patients undergoing surgical mitral valve repair
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469985/
https://www.ncbi.nlm.nih.gov/pubmed/34562939
http://dx.doi.org/10.3390/bioengineering8090117
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