La velocidad de propagación del flujo M color es un marcador sensible de disfunción diastólica en miocardiopatía chagásica
Bibliographic record
Abstract
Introduction and Objectives: Chagasic myocardiopathy is a severe health problem in Latin America. It is the first cause of dilated cardiopathy of infectious origin in Colombia.The changes described in the evaluation of the diastolic function of patients with cardiopathy are precocious and generally precede symptoms and changes in systolic function. The objective of this study is to understand the behavior of the different variables, to evaluate the diastolic function in patients at different stages of Chagas disease, and to establish whether there are early alterations that can be predictive of the progression rate of the disease. Methods: We evaluated systolic and diastolic ventricular functions in 600 patients distributed as follows: 165 (27.5%) asymptomatic patients, seronegative for Chagas disease (group 0); 277 (46.2%) seropositive asymptomatic patients (group I); 116 (19.3%) seropositive with right bundle branch block (group II); and 42 (7%) seropositive with heart failure (group III). Mitral, tricuspid and pulmonary vein flows, Doppler of mitral and tricuspid rings, color-M mode Doppler flow propagation velocity and Tei index were measured. For the descriptive analysis, the type of variable was taken into account. To establish the frequencies behavior, the Shapiro-Wilk test was used. The difference between the clinical groups was estimated by using group 0 as a baseline through Students t-test or Mann-Whitney, depending on the distribution. Statistical analysis was realized using the Stata 8.0 with a <0.05 significant difference. Results: 62.5% of the subjects were men with mean age 41.61 ± 9.38 years. The distribution among the groups was 27.5% group 0; 46.2% group I; 19.3% group II; 7% group III. For the diameter variables,, ventricular volumes and ejection fraction, a clinical deterioration among the groups was observed. Decrease of E/A relation, ,prolongation of deceleration time, A duration and isometric relaxation time (p= 0.0054; p=0.0001; p=0.0001) respectively was evidenced up to group III with a change in the measures tendency between the different groups. In the pulmonary veins the velocity of A and its duration increased in group III (p=0.007; p=0.02 respectively). There was an increment in mitral ring E/E’ relation only in group III (p=0.0001). A decrease in mitral ring E and S velocities and of the tricuspid ring E velocity and prolongation of right ventricular isovolumetric contraction time starting from group III, was noticed. The velocity of color-M mitral flow propagation presented a constant diminution from group I to group III (p=0.01; p=0.005; p=0.0002). The E velocity of the tricuspid ring also diminished in the same way (p=0.08; p=0.03; p=0.0001). The Tei index did not show significant changes between the groups. Conclusion: The diminution of the color-M mitral flow propagation velocity under 72 cm/s was the most sensible variable for the detection of left diastolic ventricular dysfunction in patients with Chagas myocardiopathy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".