Left Ventricular Regional Dysfunction Using Cardiac Magnetic Resonance Imaging in Rheumatoid Arthritis Patients Without Cardiac Symptoms: Comparison Between Methotrexate and Biologics Treatment Groups
Bibliographic record
Abstract
To the Editor: In patients with rheumatoid arthritis (RA), cardiac involvement such as myocarditis and myocardial infarction is common. This cardiac involvement may have serious consequences and can contribute to worsening of a patient’s cardiac-related morbidity and mortality1,2. Importantly, myocardial disease is typically clinically silent3, only manifesting as myocardial dysfunction after an extended preclinical phase. Cardiovascular magnetic resonance (CMR) is a sensitive noninvasive diagnostic technique that can identify subclinical myocardial structural and functional abnormalities. No systematic studies of left ventricular (LV) regional function by CMR have been conducted in patients with RA. We sought to use a CMR approach to detect LV regional dysfunction in RA patients without cardiac symptoms compared to healthy volunteers. Further, we compared LV regional function between patients with RA who were treated with methotrexate (MTX) plus biologics compared to those treated only with MTX. Consecutive patients with RA as defined by the American College of Rheumatology classification criteria were recruited from the outpatient rheumatology clinic at Itabashi Chuo Medical Center between September 2009 and December 2012. Healthy volunteers were also included in the study. Because the regional myocardial function is related to age, we have included only subjects less than 70 years old. All patients with RA received either MTX or MTX plus the biologics infliximab (IFX) or tocilizumab (TCZ). All patients and volunteers underwent nonenhanced CMR with steady-state free-precession (SSFP) cine magnetic resonance imaging (MRI) on a 1.5 Tesla MRI scanner. … Address correspondence to Dr. Y. Kobayashi, Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan. E-mail: yasukoba2{at}gmail.com
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| 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".