Abstract 165: Coronary Artery Dilatation in Kawasaki Disease is Associated with Anatomical Coronary Dominance: An Angiography-Based Study
Bibliographic record
Abstract
Introduction: Coronary artery (CA) dilatation in Kawasaki disease (KD) is best determined by elevated Z-scores. Z-score equations, do not take into account anatomical CA dominance. We hypothesize that, except for CA aneurysms, CA dominance influences dilatation status in KD (Z-score > 2.5). Material and Methods: We retrospectively analyzed CA status in KD patients followed at our institution for persistent CA dilatation. All patients who had a diagnostic catheterization between 2002 and 2012 were considered. Serial echocardiographic dimensions of LCA, RCA, and LAD upon diagnosis, 1 week, 2 weeks, 4 weeks, 2 months, 3-6 months, and 9-12 months later were normalized to BSA using published CA Z-score equations. Data were contrasted with CA angiography description of CA dominance: right or left dominance was adopted when the respective CA supplies both diaphragmatic LV free wall and posterior inter ventricular septum (IVS); Co-dominance was when posterior IVS was supplied by RCA and diaphragmatic LV free wall by LCA. Results: Of 69 potential patients, 16 were excluded (9 never presented a CA dilatation and 7 had CA aneurysms). The interval between acute onset and selective CA angiography of the remaining 53 patients was 69.5±52.8months at 9.2±5.2years old. Of the latter, 20(37.7%) had LCA-dominance, 31(58.5%) RCA-dominance, and 2(3.8%) Co-dominance. Upon KD onset, the LCA-dominant subset had 14/20(70%) ipsilateral dilatation vs. 6/20(30%) contralateral dilatation. Similarly, RCA-dominant dilatation was ipsilateral in 21/31(68%) vs. 10/31(32%) contralateral dilatation (p=0.89). On late follow-up, persistent CA dilatation was similar between LCA-dominance 6/14(43%) and RCA-dominance 10/21(47%) (p=0.94). The interval between onset and normalizing CA Z-score was 1.16±1.65 vs. 2.45±3.6years in ispilateral vs. contralateral subsets (p=0.19). From the inflammatory perspective, serum albumin was significantly lower in patients with contralateral CA dilatation (p=0.02). Nevertheless, other inflammatory markers did not show a significant difference. Conclusion: Transitory CA dilatation following KD is closely related to anatomical dominance. This may be a reflection of vasodilation during immune carditis rather than coronary vasculitis.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".