Abstract 19447: Correlation of Early Echocardiographic Right Ventricular Dimension and MRI Right Ventricular Volumes Late After Tetralogy of Fallot Repair
Bibliographic record
Abstract
Introduction: Right Ventricular End-Diastolic Volume indexed (RVEDVi) obtained by MRI is an accurate measure of RV size and a marker for secondary complications. Echo RV measurements are used early in life after TOF repair for practical reasons. We sought to examine the correlation between early echo Right Ventricular End-Diastolic Dimension z-score (RVEDDz) and MRI RVEDVi at 15 years post-repair. The relationship between these parameters and repair technique is investigated. Methods: 185 TOF patients were repaired at our institution from 1996-2002. Repair techniques were: annulus preservation (AP=124), trans-annular patch (TAP=56), and Pulmonary valve replacement (n=5, patients excluded). Data was reviewed for outcomes, echo studies, and MRI reports. A linear ordinary least square model demonstrated the relationship between early RVEDDz and late RVEDVi (n=57) . Longitudinal analysis with mixed effects model was performed on 783 serial echocardiograms (n=146) to demonstrate the effect of technique on RVEDDz progression. Results: RVEDDz at 1-5 years post-repair was a significant predicator for late RVEDVi (p=0.0016). A change in RVEDDz from 0-3 predicted an increase in RVEDVi of 28 mL. TAP repair was an independent predictor of a larger RVEDVi (p=0.0011). TAP was associated with more RV dilation throughout follow-up (0.37 RVEDDz higher every 5 years, p<0.0001). TAP patients had larger late RV volumes for the same early RVEDDz as those with AP repair (Fig. 1). The same findings were demonstrated in a sub-analysis of anatomically matched patients who could have had either TAP or AP based on surgeon choice. Conclusion: These results from a single institution support the use of RVEDDz by echo as an early maker for late MRI RV volumes in TOF. Early identification of high risk patients may influence decisions around follow-up and re-interventions. Larger population studies are needed to confirm these findings and the effects of technique on long-term RV health. Fig 1.
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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 | 0.004 |
| 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) | 0.003 | 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".