Abstract 14005: Myocardium at Risk in Revascularized Non-ST-Elevation Myocardial Infarction Assessed by Cardiac Magnetic Resonance Imaging and Validated by the Invasive Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease Score
Bibliographic record
Abstract
Background: In the setting of acute myocardial ischemia, the hypoperfused portion of the myocardium is in danger of becoming irreversibly injured. This portion of myocardium is often referred to as area at risk (AAR) and is correlated to adverse events and outcome. Hypothesis: Aim of the trial at hand was to assess the AAR in patients with acute non-ST-elevation myocardial infarction (NSTEMI) by cardiac magnetic resonance imaging (CMR). Results were validated by the well-established Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease Score (APPROACH-score) that was assessed by invasive coronary x-ray angiography. Methods: Sixty-four patients presenting with acute NSTEMI who underwent coronary x-ray angiography including subsequent percutaneous coronary intervention within 72 hours of symptom onset were enrolled. Two blinded readers performed offline angiographic AAR assessment using the modified APPROACH-score. For measurement of AAR by CMR, a 1.5 T whole-body scanner with a 32-channel phased-array surface coil was used. Besides functional and volumetric analyses, a 3D T2-weighted black-blood fat-saturated spin-echo sequence was used for visualization of myocardial edema. Area at risk was calculated as edema volume in relation to left ventricular mass. Using this technique, AAR was quantified semi-automatically by two blinded readers in consensus. Results: Mean age of study cohort was 62.9 years. Forty-four subjects were male (73.3%), mean symptom-to-balloon time was 1212 ± 976 min. The resulting mean AAR determined by the modified APPROACH-score was 28.6 ± 10.0%. The mean CMR derived AAR was 27.9 ± 13.7%. CMR assessment tended to slightly underestimate the AAR in comparison to angiographic scoring (difference -0.21 ± 8.1 %, p=NS). A good correlation between the AAR assessed by CMR and by angiography (r=0.84, p<0.0001) was observed. Conclusion: T2-weigthed CMR is able to quantify the AAR with very good correlation to the angiographic APPROACH-score in NSTEMI patients. Therefore, CMR might serve as an excellent surrogate in clinical reperfusion trials.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 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".