P.073 Cardiac dysfunction in mitochondrial disease: systematic review and metaanalysis
Bibliographic record
Abstract
Background: Cardiac dysfunction has significant impact on morbidity and mortality in patients with mitochondrial disorders. Cardiac screening tests are generally recommended because cardiac dysfunction can occur at any point in the disease course, and is amenable to treatment. However there is no clear evidence indicating the best screening strategy in patients with mitochondrial myopathy. Methods: Systematic review of the literature for cardiac investigations in adult patients with mitochondrial myopathy. We considered 1303 relevant abstracts, from which 58 full-length articles were reviewed. Seventeen articles including 701 total participants met inclusion criteria. Data extracted included age, diagnosis, and results from ECG, echocardiogram, cardiac MRI, nuclear medicine studies, and Holter monitor. Results: We identified echocardiogram and ECG as the principal screening modalities, that identify cardiac structural (26%) and conduction abnormalities (37%) in patients from various mitochondrial myopathy syndromes. Holter monitor was not a high yield investigation and limited studies were identified using cardiac MRI or nuclear medicine. Conclusions: We recommend screening with ECG and echocardiogram every 1-2 years in MERRF/MELAS, and every 3-5 years in milder syndromes when cardiac symptoms are not present. Only five of the included studies provided any follow-up data. We recommend studies of natural history, therapeutic response, and of cardiac MRI as areas for future study.
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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 | 0.010 | 0.030 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.024 |
| Bibliometrics | 0.005 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 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".