Avaliação da acurácia da ressonância magnética cardiovascular como método diagnóstico precoce na rejeição do enxerto nos receptores de transplante cardíaco
Notice bibliographique
Résumé
Introduction: Cardiac function is a progressive disease affecting millions of people. with 10% health of patients with an advanced quality health diagnosis Heart transplantation is indicated for patients with cardiac function in functional classes NY or IV of the NY Heart Association classification (New York Heart Association). one one year. After performing a heart transplant, one of the biggest challenges in patient management is the early detection of changes in the transplant. Cardiac rejection can cause severe and irreversible myocardial damage before clinical manifestations. To date, there is no monitoring of unauthorized exams for rejection of rejection. The literature considers an endomyocardial biopsy (EMB) the gold standard for the detection of rejection. Magnetic resonance imaging (MRI) is an invasive imaging modality not able to detect areas of fibrosis, edema and correction of alterations in the power to alter the screening power for heart transplantation. Thus, it starts from the idea that CMR, as it is able to assess all myocardial functionality, may offer an advantage when the gold standard assessment is lower. Objective: To evaluate the accuracy of CMR as a non-invasive diagnostic method for the early detection of acute transplant disease in heart transplant patients. Methods: Heart transplant patients who met the inclusion criteria were defined by CMR, analysis of the presence of myocardial fibrosis and quantification of myocardial edema, using the CVI-42 software (Circle Cardiovascular Imaging, Calgary, Canada). For image acquisition after GFR assessment, patients received 0.2 mmol/kg of non-ionic gadolinium-based contrast agent (gadodiamide 0.5mmol/ml) by intravenous puncture. Results: 26 heart transplant recipients were included in a Brazilian heart transplant referral hospital, from June 2019 to February 2022. Patients underwent BEM as a screening for graft rejection; the interval for performing the procedure was defined through the institution's protocol according to the Working Group of the International Society for Heart and Lung Transplantation system and according to clinical criteria assessed by the cardiologist. Patients were divided into two groups: without evidence of rejection (0R/n=13), and with rejection (>=2R n=13). Subsequently, the patients underwent CMR examination within a period of up to 120 hours, without any change in immunosuppressive therapy. Patients under 18 years of age, who had uncontrolled arrhythmias, glomerular filtration rate <30ml/min, or who had absolute contraindications for CMR were excluded. Patients with 1R rejection were also excluded from the study. Analyzes were blindly evaluated by two radiologists. The delayed enhancement (LGE) methodology was detected in (84.6%) of the patients with BEM>=2R and in (38.5%) of the patients without rejection (p=0.016). It can be stated that the fibrosis regression models defined by the quantitative analysis of the LGE was significant (p=0.022). Conclusion: It is concluded that the subjective and quantitative analyzes of the LGE can be promising in the screening of patients with suspected rejection, as stratification tools and possible reduction in the need for EMB.
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 | 0,003 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 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) | 0,003 | 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 ».