Abstract W MP68: MRI Infarct Patterns Do Not Predict Long-Term Cardiac Rhythm Recorder Findings
Bibliographic record
Abstract
Intro: It has been hypothesized that stroke/TIA patients with occult paroxysmal atrial fibrillation (PAF) have characteristic embolic patterns of cerebral infarction. We tested this hypothesis in patients studied with extended cardiac monitoring and MRI. Methods: Acute ischemic stroke patients with a negative 24-hour Holter monitor were prospectively enrolled in a study of event-triggered external loop recordings for 21 days. Fifty-five of 88 patients had acute MRI scans. Lesion volumes were calculated planimetrically on diffusion-weighted MRI (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences. Leukoaraiosis volumes (FLAIR), acute and chronic lesion number and distribution were also assessed. Results: PAF was detected in 34.5% (19/55) of patients. Duration of PAF was <30s in 52.6% (10/19) of patients. Median(IQR) DWI lesion volumes (ml) were similar between patients with (1.74 (4.57)) and without PAF (1.57 (13.39), p=0.70). Median(IQR) chronic ischemic lesion volume on FLAIR (ml) in patients with (0.34 (3.28)) and without PAF (0.28(3.01)) was similar ( P= 0.82). Leukoaraiosis volumes were also similar (8.46 (12.51) vs. 3.42 (5.25), P =0.06), as were the total number of lesions (4 (6) vs. 5 (5), P =0.48), and total number of arterial territories affected (2 (2) vs. (2 (2), P =0.09). Patients with PAF duration <30s and >30s had similar median DWI volumes (2.21 (4.08) vs. 0.13 (6.24), P =0.61), FLAIR volumes (0.34 (2.87) vs. 0.88 (12.24), P =0.89), leukoaraiosis volumes (7.69 (13.11) vs. 8.46 (26.79), P =1.00), total number of lesions (6.5 (6) vs. 3 (7), P =0.72), and total number of arterial territories affected (3 (2) vs. 2 (3), P =0.84). Conclusion: Ischemic lesion volume, number and distribution in patients with occult PAF are similar to those with other mechanisms of infarction. In addition, patients with even very brief runs of PAF (<30s) have similar ischemic lesion loads to those with longer duration episodes. Our data suggest all ischemic stroke patients should be investigated for PAF.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 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".