Association Between Clinical Depression and Endothelial Function Measured by Forearm Hyperemic Reactivity
Bibliographic record
Abstract
Objective: To assess associations between clinically significant depression (major depressive disorder [MDD] and minor depressive disorder [MiDD]) and endothelial function (EF), via forearm hyperemic reactivity (FHR), in patients referred for myocardial perfusion imaging. Studies have linked MDD to impaired EF, an early marker of coronary heart disease (CHD) and risk factor for cardiac events, in healthy, noncardiac patients, although no studies have assessed the MDD-EF association in patients with or at risk for CHD. Methods: Depression was assessed, using the Primary Care Evaluation of Mental Disorders structured interview in 323 patients (n = 242 men; mean age = 59 years) with or at risk for CHD. FHR was assessed, using a dynamic nuclear imaging technique that measures the dilatory capability of the brachial artery during hyperemic challenge. The relative uptake ratio (RUR) of blood flow between hyperemic and nonhyperemic arms was used to measure FHR. Results: Patients with MDD and MiDD had lower RURs (mean values = 3.31 and 3.34, respectively), indicating poorer EF than patients without depression (mean = 4.27) (F = 5.19, p < .01), irrespective of CHD status. All results were adjusted for covariates including sociodemographic, medical, biochemical, and physiological variables. Conclusions: Patients with clinical levels of depression had worse FHR than patients without depression, irrespective of CHD status and after adjusting for covariates. Data extend previous findings, suggesting that the link between clinical depression and worse CHD outcomes may be mediated by EF. BDI = Beck Depression Inventory; CHD = coronary heart disease; CRP = C-reactive protein; DSM = Diagnostic and Statistical Manual; EF = endothelial function; FHR = forearm hyperemic reactivity; FMD = flow-mediated dilatation; HPA = hypothalamic-pituitary-adrenal; MDD = major depressive disorder; MiDD = minor depressive disorder; MI = myocardial infarction; NO = nitric oxide; PRIME-MD = Primary Care Evaluation of Mental Disorders; RUR = relative uptake ratio; SCID = Structured Clinical Interview for DSM; SPECT = single photon emission computed tomography.
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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 | 0.003 |
| 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) | 0.001 | 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".