{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:27:26Z","timestamp":1768696046362,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T00:00:00Z","timestamp":1691280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Our study hypothesized that an intelligent gradient boosting machine (GBM) model can predict cerebrovascular events and all\u2010cause mortality in mitral stenosis (MS) with atrial flutter (AFL) by recognizing comorbidities, electrocardiographic and echocardiographic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The machine learning model was used as a statistical analyzer in recognizing the key risk factors and high\u2010risk features with either outcome of cerebrovascular events or mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2184 patients with their chart data and imaging studies were included and the GBM analysis demonstrated mitral valve area (MVA), right ventricular systolic pressure, pulmonary artery pressure (PAP), left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) class, and surgery as the most significant predictors of transient ischemic attack (TIA\/stroke). MVA, PAP, LVEF, creatinine, hemoglobin, and diastolic blood pressure were predictors for all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The GBM model assimilates clinical data from all diagnostic modalities and significantly improves risk prediction performance and identification of key variables for the outcome of MS with AFL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.13078","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T05:36:35Z","timestamp":1691386595000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Predicting stroke and mortality in mitral stenosis with atrial flutter: A machine learning approach"],"prefix":"10.1111","volume":"28","author":[{"given":"Amer","family":"Rauf","sequence":"first","affiliation":[{"name":"Department of Electrophysiology Armed Forces Institute of Cardiology  Rawalpindi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asif","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Cardiology KMU Institute of Medical Sciences  Kohat Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usha","family":"Rathi","sequence":"additional","affiliation":[{"name":"Abbasi Shaheed Hospital  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-1718","authenticated-orcid":false,"given":"Zainab","family":"Ashfaq","sequence":"additional","affiliation":[{"name":"Department of Medicine CMH Lahore Medical College  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidayat","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Cardiology Pakistan Atomic Energy Commission Hospital  Islamabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amna","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Department of Medicine Military Hospital Rawalpindi  Rawalpindi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jateesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medicine Jinnah Sindh Medical University  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Faraz","sequence":"additional","affiliation":[{"name":"Department of Business Development Bahria University  Islamabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waheed","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Abbas Institute of Medical Sciences  Muzaffarabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9343-4187","authenticated-orcid":false,"given":"Amin","family":"Mehmoodi","sequence":"additional","affiliation":[{"name":"Department of Medicine Ibn e Seena Hospital  Kabul Afghanistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jahanzeb","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology Armed Forces Institute of Cardiology  Rawalpindi Pakistan"},{"name":"Department of Cardiovascular Research Cardiovascular Analytics Group  Rawalpindi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.10.025"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.14495"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2018.04.014"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1109\/TNNLS.2018.2874458"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics9040178"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccep.2020.11.003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2202\/1544\u20106115.1691"},{"issue":"2","key":"e_1_2_10_9_1","first-page":"105","article-title":"Arrhythmias in the natural history of mitral stenosis","volume":"47","author":"Horstkotte D.","year":"1992","journal-title":"Acta Cardiologica"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2019.09.03"},{"issue":"1","key":"e_1_2_10_11_1","first-page":"10","article-title":"Effects of severity of mitral stenosis on left and right ventricular function at rest and during exercise","volume":"2","author":"Johnston D. 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