Ultrasound evaluation of left ventricular and aortic fibrosis after pre‐eclampsia
Bibliographic record
Abstract
ABSTRACT Objectives Myocardial fibrosis is associated with adverse clinical outcome in adults. Our aim was to investigate using echocardiographic calibrated integrated backscatter (cIBS) the presence of myocardial and/or aortic fibrosis in asymptomatic women with a history of early‐onset (EO) or late‐onset (LO) pre‐eclampsia (PE). Methods Thirty non‐pregnant women whose most recent pregnancy was complicated by EO‐PE, 30 with previous LO‐PE pregnancy and 30 controls who had experienced only uncomplicated pregnancy previously were selected retrospectively from our electronic database and recalled between 6 months and 4 years after delivery. Data regarding gestational age (GA) and mean uterine artery (UtA) pulsatility index (PI) at diagnosis of PE were collected from their medical records. The women underwent cardiovascular assessment, during which the presence of fibrosis was investigated, by means of cIBS, at the basal interventricular septum (cIBS IVS ), the basal posterior wall (cIBS PW ) and the anterior wall of the ascending aorta, 3 cm above the valve (cIBS AO ). These findings were compared between the three patient groups. Results Using cIBS imaging, we found significant left ventricular (LV) fibrosis in women with a history of EO‐PE compared with those with previous LO‐PE pregnancy and controls (intergroup ANOVA P < 0.001 for cIBS IVS and P = 0.005 for cIBS PW ), whereas aortic fibrosis did not differ significantly among cases and controls. Stepwise multivariate regression analysis showed that LV fibrosis was associated independently with lower GA and higher mean UtA‐PI at diagnosis of PE, while cIBS AO correlated with aortic diameters, stiffness and ventricular–arterial coupling. Conclusions Women with a history of EO‐PE show LV fibrosis in the short–medium term after delivery compared with women with previous LO‐PE pregnancy and controls. LV fibrosis is associated with GA and mean UtA‐PI at onset of PE. Larger studies using cardiac magnetic resonance imaging are needed to validate and confirm our findings. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.065 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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) | 0.000 | 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 teacher head, 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".