Abstract 14052: Mental Stress is Associated with More Transient Ischemic Dilatation of the Left Ventricle Than Physical Stress
Bibliographic record
Abstract
Objective: Mental stress (MS) has been postulated to worsen coronary microvascular function. Mental stress-induced ischemia (MSI) predicts adverse events but does not correlate with CAD severity. Transient ischemic dilation (TID) detected with myocardial perfusion imaging is a measure of dilation in left ventricular cavity size with stress. However, TID may also reflect subendocardial hypoperfusion and impaired coronary flow reserve due to coronary microvascular disease. We addressed the hypotheses that MS is associated with larger TID as compared to physical stress (PS), and that patients with MSI have the largest TID. Methods: 478 patients with CAD underwent 99mTc[[Unable to Display Character: ‐]]sestamibi myocardial perfusion imaging at rest and following both mental and physical (exercise/ pharmacological) stress testing. TID with each stress was calculated using Emory Cardiac Toolbox software. A 17-segments model was used to calculate summed stress scores to quantify perfusion defects with MS, PS, and at rest. TID with each stress condition and the difference between the two stress conditions were compared according to ischemia status. Results: Ninety-three patients (19%) developed mental stress ischemia (MSI+), 131 (27%) developed physical stress ischemia (PSI+); 50 (10%) developed both MSI and PSI. Both MS and PS were associated with TID, but MS was associated with a larger increase in TID than PS (within-subject delta (δ) MS [[Unable to Display Character: –]] PS) = 0.02, p = 0.003). This difference was significantly larger in MSI+ patients (δMSI+ = 0.05, p = 0.002) than in MSI negative subjects (δMSI- = 0.01, p = 0.18). In contrast, PSI+ had a similar TID with PS and MS (δPSI+ = -0.003, p = 0.80). These results remained unaltered after adjustment by sociodemographic factors (age, sex, race, smoking status) and medical history (hypertension, hyperlipidemia and diabetes). Conclusion: Mental stress is associated with TID, particularly in subjects who are MSI positive. TID may be a marker of subendocardial ischemia and coronary microvascular dysfunction in response to mental stress.
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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 | 0.001 |
| 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) | 0.013 | 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".