Abstract 16282: Coronary Fibromuscular Dysplasia Angiographic Manifestations
Bibliographic record
Abstract
Background: We previously described a strong association between fibromuscular dysplasia (FMD) and spontaneous coronary artery dissection (SCAD). Angiographic manifestation of coronary FMD aside from dissection was reported to be rare. However, we observed several non-dissection coronary angiographic abnormalities in patients with multifocal FMD. Methods: Baseline demographics and imaging of patients with suspected non-dissection coronary FMD at Vancouver General Hospital were retrospectively reviewed. Presence of multifocal FMD in non-coronary territories was confirmed by 3 specialists. Coronary angiograms with suspected coronary FMD changes (excluding dissected segments) were reviewed and classified by 2 experienced angiographers for: (1) irregular stenosis (beading) - multiple areas of stenosis in a focal or diffuse pattern and with/without systolic accentuation, (2) smooth stenosis - diffuse or focal, (3) segmental dilatation/ectasia, and (4) tortuosity. Optical coherence tomography (OCT), if performed, were reviewed by 2 specialists. Results: Of 28 patients with multifocal FMD and suspected coronary involvement on angiography, 23 were women (82.1%), mean age was 58.6 ± 9.5, and mean BMI was 24.6. Sixteen presented with myocardial infarction (10 due to SCAD), 12 underwent angiography for stable or atypical angina. The observed coronary angiographic abnormalities were: irregular stenosis (beading) in 14 (12 diffuse, 2 focal, 3 with systolic accentuation), smooth stenosis in 6 (4 diffuse, 2 focal), segmental dilatation/ectasia in 14 (majority with multi-segmental, diffuse enlargement in an entire vessel), and tortuosity in 25 cases. Fourteen patients had OCT of the abnormal segments showing abnormalities distinct from atherosclerosis. These included multiple areas of patchy or diffuse intimal, medial or adventitial abnormalities with disorganized fibrotic thickening, proteoglycan accumulation, macrophage infiltration, loss of elastic membranes, and cavitation. Conclusions: This is the first case series describing angiographic manifestations of coronary FMD, which can be categorized into irregular stenosis, smooth stenosis, dilatation and tortuosity, representing features that are additional to dissection.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.006 | 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".