{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T08:05:01Z","timestamp":1792829101981,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Severe functional mitral regurgitation (FMR) may benefit from mitral transcatheter edge-to-edge repair (TEER), but selection of patients remains to be optimized.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this study was to use machine-learning (ML) approaches to uncover concealed connections between clinical, echocardiographic, and haemodynamic data associated with patients\u2019 outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Consecutive patients undergoing TEER from 2009 to 2020 were included in the MITRA-AI registry. The primary endpoint was a composite of cardiovascular death or heart failure (HF) hospitalization at 1 year. External validation was performed on the Mitrascore cohort. 822 patients were included. The composite primary endpoint occurred in 250 (30%) patients. Four clusters with decreasing risk of the primary endpoint were identified (42, 37, 25, and 20% from Cluster 1 to Cluster 4, respectively). Clusters were combined into a high-risk (Clusters 1 and 2) and a low-risk phenotype (Clusters 3 and 4). High-risk phenotype patients had larger left ventriculars (LVs) (&amp;gt;107\u2005mL\/m2), lower left ventricular ejection fraction (&amp;lt;35%), and more prevalent ischaemic aetiology compared with low-risk phenotype patients. Within low-risk groups, permanent atrial fibrillation amplified that of HF hospitalizations. In the Mitrascore cohort, the incidence of the primary endpoint was 48, 52, 35, and 42% across clusters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A ML analysis identified meaningful clinical phenotypic presentations in FMR undergoing TEER, with significant differences in terms of cardiovascular death and HF hospitalizations, confirmed in an external validation cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztaf006","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T14:26:36Z","timestamp":1739456796000},"page":"340-349","source":"Crossref","is-referenced-by-count":10,"title":["Machine-learning phenotyping of patients with functional mitral regurgitation undergoing transcatheter edge-to-edge repair: the MITRA-AI study"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6646-9317","authenticated-orcid":false,"given":"Fabrizio","family":"D\u2019Ascenzo","sequence":"first","affiliation":[{"name":"Division of Cardiology, Cardiovascular and Thoracic Department, \u2018Citta della Salute e della Scienza\u2019 Hospital , Corso Bramante n 88, Turin 10126 ,","place":["Italy"]},{"name":"Department of Medical Sciences, University of Turin , Via Verdi 8, Turin 10126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Angelini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiovascular and Thoracic Department, \u2018Citta della Salute e della Scienza\u2019 Hospital , Corso Bramante n 88, Turin 10126 ,","place":["Italy"]},{"name":"Department of Medical Sciences, University of Turin , Via Verdi 8, Turin 10126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Pancotti","sequence":"additional","affiliation":[{"name":"Department of Medical Science, University of Turin, Via Santena 19 , 10126 Torino ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7868-1852","authenticated-orcid":false,"given":"Pier Paolo","family":"Bocchino","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Cardiovascular and Thoracic Department, \u2018Citta della Salute e della Scienza\u2019 Hospital , Corso Bramante n 88, Turin 10126 ,","place":["Italy"]},{"name":"Department of Medical Sciences, University of Turin , Via Verdi 8, Turin 10126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5472-6881","authenticated-orcid":false,"given":"Cristina","family":"Giannini","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Carlo Gnocchi ONLUS , Milan 20148 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Finizio","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Mediterranea Cardiocentro , Napoli ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-1815","authenticated-orcid":false,"given":"Marianna","family":"Adamo","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Camman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart Center, University Hospital Zurich , Zurich 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