Abstract 16036: Interest of Central Arterial Compliance in the Occurence of Discordant Grading in Aortic Stenosis
Bibliographic record
Abstract
Introduction: According to the current AHA/ACC guidelines, severe aortic stenosis (AS) is defined as a peak aortic jet velocity (Vpeak) >4m/sec, a mean gradient (MG) >40 mmHg, and/or an aortic valve area (AVA) 2 . However, cardiologists are often confronted to discordant echocardiographic findings that are unexplained by a reduction in transvalvular flow. Discordances may raise uncertainty about the actual severity of the disease and thus therapeutic management. Aim: The aim of this study was to identify the causes of such discordance by measuring systemic arterial compliance (SAC), which could interfere with the evaluation of AS. Methods: Fifty-two men with mild to moderate AS underwent Doppler-echocardiography, multidetector computed tomography (MDCT), and central and peripheral blood pressure were measured in the context of the prospective PROGRESSA study. SAC was calculated as the stroke volume (SV) divided by the systemic pulse pressure (systolic blood pressure [SBP] - diastolic blood pressure [DBP]). Results: The mean age was 63±13 years and MG 21±8 mmHg. There was a significant correlation between aortic valve calcification (AVC) and MG (r=0.62; p Conclusions: This study shows that for the same anatomic AS severity, patients with reduced SAC have a decreased MG. In these patients, AS severity could be underestimated and lead to an inappropriate treatment. In addition, patients may appear to have normal SAC when assessed in periphery despite decreased central SAC. Thus AS severity should be assessed by an alternative exam, such as MDCT, in any patient with discordant low gradient not obviously linked to measurement error.
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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 | 0.002 | 0.006 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".