Acute haemodynamic improvement with cardiac resynchronisation therapy is predicted by baseline haemodynamic status
Bibliographic record
Abstract
Purpose: Acute haemodynamic improvement with cardiac resynchronisation therapy (CRT) is often used to guide optimization of device function, and may predict long term response to therapy. QRS duration reportedly correlates with acute haemodynamic response to CRT but other predictors are not known. We investigated whether baseline invasive haemodynamic parameters predict acute haemodynamic response to CRT. Methods: We performed a retrospective, single centre study of patients who had intra-arterial BP measurement via radial arterial line at baseline and acutely following CRT implantation. Of these patients, the majority additionally underwent right heart catheterization (RHC) immediately prior to CRT. We analysed the relationship between baseline haemodynamic parameters (pulse pressure (PP), pulmonary capillary wedge pressure (PCWP) and cardiac index (CI)) and acute pulse pressure change in response to CRT (delta PP). Results: 224 patients had invasive arterial BP measurements recorded pre- and post-CRT. Of these patients, 180 had RHC. Baseline CI correlated with baseline PP (Pearson r=0.297, p<0.0001). CRT significantly increased PP from 54.8±15.8mmHg to 59.1±15.6mmHg (p<0.0001), resulting in a mean delta PP of 4.4±1.5mmHg. There was inverse correlation between baseline PP and delta PP (r= -0.227, p=0.0006), and baseline CI and delta PP (r= -0.199, p=0.008), and a positive correlation between baseline PCWP and delta PP (r=0.281, p=0.0001, Figure 1). Figure 1 Conclusions: Adverse baseline haemodynamic status, characterised by narrower PP, lower CI, and higher PCWP, is associated with greater increments in PP acutely following CRT.
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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 | 0.001 | 0.004 |
| 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 | 0.001 |
| 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".