Abstract 19383: Reduced Longitudinal and Circumferential Strains with Radial Compensation in End Stage Renal Disease Patients Despite Normal Ejection Fraction
Bibliographic record
Abstract
Background: Patients with end stage renal disease (ESRD) have high prevalence of heart failure despite normal left ventricular (LV) ejection fraction (EF) leading to adverse outcomes and higher mortality. Hence, we prospectively assessed LV strain patterns in ESRD patients with normal EF. Methods: We prospectively evaluated 100 ESRD patients with normal EF and wall motion and compared them to 22 age and gender matched controls. Complete demographic, clinical and echocardiographic data were collected. LV longitudinal, circumferential and radial strains were computed using speckle tracking echocardiography and corresponding end systolic wall stresses were calculated using Mirsky’s formulae. Results: The mean age was 54 years, 41% men, 53% had diabetes, mean EF was 65% and 15% had heart failure. The global longitudinal and mid LV circumferential strains were significantly lower in patients with ESRD with normal EF compared to the age and gender matched controls (-15.7+7.9% vs -20.4+4.1%, p=0.02 and 19.8+6.2% vs 25.2+3.8%, p=0.01 respectively). However, the radial strain was marginally higher compared to the controls (26.2+15.4% vs. 17.4+9.6%, p=0.07). Normalized for the corresponding wall stresses, only the circumferential strain was lower in ESRD patients and longitudinal and radial stresses were similar between the groups. Conclusions: 1) Global longitudinal and circumferential strains are reduced accompanied by an increase in radial strain in ESRD patients with normal EF. 2) This may only partly be explained by changes in wall stress and reflects incipient LV myocardial dysfunction. 3) Evaluation and targeting of abnormalities of LV wall stress and strain in this high risk population may help obviate heart failure and its deleterious consequences.
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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".