10 Quantitative myocardial perfusion and longitudinal strain by feature tracking in newly diagnosed, treatment naïve rheumatoid arthritis
Bibliographic record
Abstract
Objectives Rheumatoid arthritis (RA) is associated with increased cardiovascular mortality. Proposed mechanisms include coronary microvascular dysfunction due to immune dysregulation and systemic inflammation. First pass myocardial perfusion CMR allows quantification of myocardial blood flow (MBF) and myocardial perfusion reserve (MPR). In the absence of coronary artery disease (CAD), reduced MPR represents coronary microvascular dysfunction. We hypothesised MPR would be reduced in RA and that abnormalities in left ventricular (LV) deformation would be evident in RA, as LV mass has been reported to be reduced in established disease. Methods Twelve patients with newly diagnosed, treatment naïve RA and 12 healthy volunteers (HV) underwent CMR at 3.0T (Phillips Achieva TX). Both groups had no history of CAD. Dual bolus resting and stress perfusion imaging was performed (0.1mmol/kg Gadolinium DTPA) and MBF estimated for the mid ventricular slice using Fermi constrained convolution (PMI v 0.4 [Sourbron, 2009]). Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) by feature tracking were calculated using bSSFP images (CVI 42, Circle Cardiovascular Imaging, Calgary, Canada). Results Mean age of RA patients was 48 ± 16 and mean age of HV 47 ± 14. Of the RA patients, 4 were male and 8 female. Of the HV, 2 were male and 10 female. Mean MPR values were 1.98 ± 0.79 and 1.99 ± 0.72 (P = 0.88) for RA and HV respectively (Figure 1). Mean values for LVEF were 63 ± 4 and 62 ± 4% (P = 0.48) respectively for RA patients and HV. Mean values for GLS were −20.2 and −21 ± 0.4 (P = 0.396) for RA and HV respectively. Conclusion These findings suggest treatment naïve RA patients have no detectable abnormalities on perfusion CMR. Therefore, whilst present in established RA, coronary microvascular dysfunction may not yet have developed in early RA. No abnormalities of LV systolic function were evident and may be a later manifestation of RA.
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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) | 0.001 | 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".