Reperfusion hemorrhage is a marker for the severity of tissue injury in patients with acute ST-elevation myocardial infarction
Bibliographic record
Abstract
T2*-weighted cardiovascular magnetic resonance (T2*-CMR) accurately quantifies myocardial reperfusion hemorrhage in vivo. The aim of this study was to assess the relationship of hemorrhage to microvascular obstruction (MO), infarct size and functional parameters in patients with acute myocardial infarction. In 19 patients (age 57 ± 11), a CMR study was performed 6 ± 1 days after reperfusion therapy for acute ST-elevation myocardial infarction. In a short axis orientation, covering the entire left ventricle (slice thickness 10 mm/0 mm), the following sequences were obtained: cine SSFP images for functional and volumetric analyses, T2*-weighted GE-EPI for hemorrhage; after injection of 0.1 mmol/kgBW early post-conrast IR-GE images were obtained for MO, and after 10 min, late gadolinium enhancement images were obtained for infarct size. Images were analyzed semi-quantitatively using a threshold-based signal detection. Myocardial infarction occurred without microvascular injury in 6 patients (group MO-), 3 patients had microvascular obstruction but no hemorrhage (group MO+H-), and hemorrhage within the microvascular obstruction zone was observed in 10 patients (group MO+H+). Hemorrhage was associated with larger infarct size (MO- 12.6 ± 1.8 g, MO+H- 14.9 ± 5.0 g, MO+H+ 61.9 ± 7.8 g; p < 0.01), greater amount of microvascular obstruction (MO+H- 2.2 ± 1.2 g, MO+H+ 12.2 ± 2.2 g, p < 0.05), and lower LV ejection fraction (MO- 61 ± 6%, MO+H- 63 ± 1%, MO+H+ 35 ± 5%; p < 0.05). There was a linear relationship between infarct size and the amount of microvascular obstruction (R = 0.80; figure 3), infarct size and amount of hemorrhage (R = 0.77), as well as amount of microvascular obstruction and amount of hemorrhage (R = 0.84). An infarct mass of 25 g and microvascular obstruction of more than 5 g predicted hemorrhagic infarcts with 100% accuracy. T2*-CMR accurately quantifies hemorrhage in vivo as a novel diagnostic target in myocardial reperfusion injury. Hemorrhage may be a complication of reperfusion at an advanced stage of ischemic injury.
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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 | 0.001 | 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".