Abstract 694: More Extensive Left Ventricular Hypertrophy in Transthyretin-Type Cardiac Amyloidosis as Compared to Primary Light-Chain Cardiac Amyloidosis
Bibliographic record
Abstract
Background : Cardiac amyloidosis is generally described as a disease with left ventricular (LV) wall thickening, but data supporting LV morphologic differences between types of amyloidosis are lacking. We sought to examine LV morphologic differences between patients with light chain (AL) and transthyretin (TTR)-type amyloidosis with cardiac involvement using volumetric cardiovascular magnetic resonance (CMR). Methods : Patients with proven AL (n =21) and TTR amyloidosis (n =14) underwent cine CMR using standard methods. Volumetric LV mass, LV volumes, and LV mass/volume ratio were measured by an independent core lab blinded to all patient data, using a contiguous short-axis stack of images covering the left ventricle. Results : Both groups demonstrated a male predominance (TTR 86%, AL 67%) with patients in the TTR group older than AL group (74±8yr vs 61 ± 12yr p=0.002). There were no differences in the degree of heart failure symptoms in the TTR and AL groups: NHYA Class I: 4 vs 5; Class II/III: 9 vs 15; Class IV: 0 vs 1, respectively (p=0.68). The maximum anteroseptal thickness was greater in the TTR group (17.9 ± 3.6mm vs. 14.1 ± 3.3mm; p<0.001). Left ventricular end-diastolic mass was also greater in TTR compared to AL amyloid (236 ± 63g vs. 186 ± 61 g; p=0.02) with no significant difference in LV end-diastolic volume (TTR: 154 ± 32 ml vs. 155 ± 45 ml; p=0.89). The LV mass to volume ratio for TTR amyloidosis was significantly greater than the AL group (1.58 ± 0.5 vs. 1.24 ± 0.4; p=0.02). Conclusions : These data demonstrate that LV morphology differs between TTR and AL cardiac amyloidosis, with increased wall thickness and mass in TTR despite similar baseline symptoms and clinical characteristics. Given the reported more aggressive course of AL vs. TTR cardiac amyloidosis, the clinical significance of these findings needs to be further evaluated.
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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 | 0.001 | 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) | 0.006 | 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".