Abstract 8889: Isovolumic Acceleration Correlates with Single Ventricle Pre or Post Fontan Ventricular End Diastolic Pressure, Not E/e′
Bibliographic record
Abstract
Background: Estimation of diastolic function in single ventricle (SV) hearts with varied ventricular loading from staged palliative surgery is particularly challenging. To define the best non-invasive correlate of diastolic function in SV, we studied the relationship between echocardiography function parameters, and invasively measured end diastolic pressure (EDP) of the dominant ventricle in SV patients. Methods and Results: Thirty SV patients, mean age 41±11 months, with cardiac catheterization pre (n=20) or post Fontan (n=10), had their most closely associated echocardiogram (median 3.5, 0.6 to 9.9 months), assessed using conventional and color tissue Doppler imaging (TDI) parameters for systolic and diastolic function. Echocardiogram parameters and catheter-derived data were explored for linear correlations with p<0.05 being significant. The EDP and mean pulmonary artery (PAP) pressures were 6.5±3.5 and 9.6±3.4 mmHg respectively. No significant correlation was found between echocardiography diastolic parameters, early and late peak inflow velocities (E, A and E/A), TDI annular velocities (e′, a′ and E/e′), pulmonary venous Doppler spectra, isovolumic relaxation time, atrial size and function, and invasively measured EDP or PAP. Systolic parameters, ventricular annular excursion, TDI (s′ and Tei index), ventricular size and function, had no significant correlation with EDP or PAP. Only isovolumic acceleration (IVA), a mostly load independent non-invasive measure of myocardial contractility, held a highly significant negative correlation with EDP (Figure). Conclusions: Decreased IVA, a marker of reduced myocardial contractility, has the best non-invasive correlate with invasively measured EDP in SV. In contrast E/e′ and other parameters of diastolic function do not. Current echocardiographic diastolic parameters established in adults with heart failure may not be useful in SV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".