The central role of the endothelium in graft coronary vasculopathy and heart transplantation.
Bibliographic record
Abstract
BACKGROUND: Despite the successes and advances made in clinical heart transplantation, the number one culprit and greatest cause of death beyond the first year remains graft coronary vasculopathy. The study of the central role of the endothelium in the development of graft coronary vasculopathy has been aided by the numerous advances in basic science, which have enhanced our understanding of endothelial physiology. METHODS: Several experimental strategies are reviewed, such as the in vivo porcine heterotopic heart transplantation model and the in vivo and in vitro exposure of coronary and renal arteries to immunosuppressive drugs. Other studies are reviewed, including vascular biology studies that examine the role of acute and chronic rejection, hypercholesterolemia, inhibition of endothelial nitric oxide synthase, denudation of the endothelium, and immunosuppressive drugs in coronary endothelial function and intimal hyperplasia; studies that assess the acute and remote effects of different cardioplegic and preservation solutions used for transplantation; and studies that test novel therapies for pulmonary endothelial dysfunction and hypertension. RESULTS: These studies highlight the target factors that ensure preservation of the protective role of the coronary endothelium on the vascular wall, including the control of immunological damage, treatment of hypercholesterolemia, use of optimal cardioplegic and preservation strategies, and the prevention and treatment of pulmonary endothelial dysfunction after exposure to cardiopulmonary bypass and heart transplantation. CONCLUSION: Further research should focus on improving human lymphocyte antigen matching of donor and recipients, improving immunosuppressive regimens, and preserving graft coronary endothelial function and the pulmonary circulation to positively modify the survival curve of transplant recipients.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".