Abstract 11959: Cardiac Denervation Appears Before Becoming Myocardial Tissue Fibrosis in Patients With Cardiac Involvement Sarcoidosis and Active Inflammation Using C-11 Hydroxyephedine PET/CT and Cardiac Magnetic Resonance
Bibliographic record
Abstract
Background: Cardiac involvement sarcoidosis (CS) has increased risk of arrhythmia linked to sudden death. Cardiac sympathetic nervous (SNS) dysfunction may play an important role for these events. However, the association between the SNS dysfunction and active inflammation or tissue fibrosis has not been studied. The aim of this study was to evaluate the left ventricle (LV) SNS dysfunction measured by C-11 hydroxyephedrine (HED) positron emission tomography (PET)/CT and its association with tissue fibrosis measured by cardiac magnetic resonance (CMR) in patients with CS and active inflammation. Methods: Eleven patients with CS based on the JMHW guidelines (1993) were enrolled. CS (age 59±16 y) and preserved LVEF (64±14 %) underwent HED PET, FDG PET, and CMR. Ten healthy controls underwent HED PET. LV wall was divided into 17 segments. Reduced HED uptake, focal FDG uptake, and late gadolinium enhancement (LGE) on CMR were defined as positive for the visual assessment. In addition, whole LV and regional HED uptake was quantitatively assessed by retention index (RI). Standard uptake value (SUV) was measured in the FDG positive segments. Results: CS had reduced global LV HED RI compared to control (0.09±0.04 vs. 0.15±0.03 %/min, P<0.001). FDG positive group (n=7) had lower global HED RI than FDG negative group (n=4) (0.065±0.027 vs. 0.130±0.040 %/min, P=0.010). In contrast, there was no significant difference in LGE positive segments numbers between the two groups (3.14±2.79 vs. 1.25±0.96, P=0.46). In segmental analysis, the percentage of abnormal segments were trend to higher in HED than LGE (P=0.19). In addition, there was no correlation between regional FDG SUV and HED RI (n=42 segments, R=-0.11, P=0.50). Conclusions: Cardiac involvement sarcoidosis with active LV inflammation and preserved LVEF showed global LV cardiac sympathetic nervous dysfunction. Denervation area was tended to be larger than tissue fibrosis. Furthermore, no association was seen between FDG uptake and HED retention index in regional level. These findings may imply that multiple factors other than inflammatory process and tissue fibrosis may be involved in the cardiac sympathetic nervous dysfunction in cardiac involvement sarcoidosis.
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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) | 0.002 | 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 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".