P4644Distribution of newly defined subtypes of interatrial communications in 7,000 newborns from a general population study
Notice bibliographique
Résumé
Abstract Introduction The prevalence of interatrial communications (IACs) (patent foramen ovale (PFO) or atrial septal defect (ASD)) in newborns has previously been reported to be between 24% and 92%. However, previous studies were generally small, and no universal classification of IACs exists. We proposed a new echocardiographic diagnostic algorithm developed in collaboration with a group of international experts to classify IACs into subtypes based on echocardiographic findings on transthoracic echocardiographic (TTE) images of the atrial septum in unselected newborns. Purpose To describe the distribution of the six newly defined subtypes of IACs in newborns based on the new diagnostic algorithm. Method Echocardiograms of newborns (age 0–30 days) consecutively included in a large, prospective population study (n=25,000) were analyzed using the new algorithm. The algorithm classifies IACs into three subtypes of PFO and three subtypes of ASD based on subxiphoid TTE findings considering the normal fetal development. The images were examined for colour Doppler signal possibly crossing the atrial septum, with or without acceleration, and with or without a visible communication on 2D. Furthermore, the size and morphology (channel-like structure or open hole) of a possible IAC as well as the number of communications were evaluated in determining the subtype of IAC according to the algorithm. The three subtypes of PFO were determined as follows: PFO1 were only detectable using colour Doppler; PFO2 had a channel-like structure visible on 2D; and PFO3 had a diameter of ≤3.4 mm and no channel-like structure. The three subtypes of ASD were determined as follows: ASD1 had a diameter of >3.4 mm; ASD2 was located in the inferior 1/3 part of the septum; and ASD3 had more than one IAC. Preliminary results As of 3 February 2019, 9,028 echocardiograms have been analyzed. A total of 2,026 (22.4%) were excluded due to poor image quality of the atrial septum. Of the 7,002 included echocardiograms, an IAC was detected on the TTE images in 85.9% of the newborns (median age 12 days [IQR 8; 15], 47.9% females). According to the algorithm, 78.7% of the newborns were classified as having a PFO (35.0% had a PFO1; 21.8% had a PFO2; and 21.9% had a PFO3) whereas 7.2% were classified as having an ASD (3.5% had an ASD1; 0.2% has an ASD2; and 3.5% had an ASD3) (see Figure 1). Figure 1. Distribution of subtypes Conclusion An IAC was present in the vast majority of newborns aged 0–30 days. The most frequent PFO subtype was PFO1, which was only detectable by colour Doppler and was 1.6 times more frequent than the two other PFO subtypes, which had equal frequencies. The most uncommon ASD subtype was ASD2 which was located in the lower 1/3 part of the atrial septum and was 17.5 times less frequent than the ASD1 and ASD3 subtypes, which had equal frequencies. (Figure 1: PFO: Patent foramen ovale, ASD: Atrial septal defect, IAC: Interatrial communication) Acknowledgement/Funding Danish Heart Association, Danish Children's Heart Foundation, Candy's Found., Toyota Found., Herlev-Gentofte Hospital Research Found., Gangsted Found.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».