285Myocardial and cerebral oxygenation deficits in heart failure patients - a multi-parametric study
Bibliographic record
Abstract
OnBehalf: MUHC CMR Group Introduction: Cognitive decline is a known co-morbidity of Heart Failure. Many different pathophysiological mechanisms have been suggested as etiologies underlying the development of cognitive impairment such as cerebral hypoperfusion as a result of reduced cardiac output, decreased cerebrovascular reactivity, microvascular dysfunction, arterial hypertension, and increased chronic proinflammatory response. In compromised vasculature, increased oxygen demand without an accompanying increase in blood flow would result in increased levels of deoxyhemoglobin and an SI decrease, signalling microvascular dysfunction. Purpose: Assess the myocardial and cerebral oxygenation reserve deficits utilizing the blood oxygen level dependent properties of Oxygenation-Sensitive MRI (OS-MRI) in heart failure patients. Methods: Twelve heart failure patients (mean age 64 ± 9 years; 36% female) and fourteen age-matched healthy volunteers (mean age 56 ± 5 years; 64% female) underwent a CMR on a clinical 3T scanner (Skyra, Siemens, Erlangen, Germany). CMR functional parameters were obtained from standard SSFP cine images cine biplanar long-axis images. OS CMR images were obtained in a basal and mid-ventricular short-axis slice. The global Myocardial Oxygenation Reserve (MORE) was obtained from oxygenation sensitive SSFP short-axis cine images were acquired at resting baseline and continuously during a voluntary maximal breath-hold following a 60s period of hyperventilation. The cerebral BOLD images were obtained in the axial plane covering the full cerebrum. The global Cerebral Oxygenation Reserve (CORE) was obtained from subtraction images delineating the global signal intensity differences obtained on BOLD images in the grey matter of the brain. Results: Heart failure patients (LVEF = 40.98+/-14.18%) had a significantly lower left ventricular ejection fraction (LVEF) when compared to healthy controls (LVEF = 69.46+/-6.79%) (p < 0001). The percent-change in signal intensity in brain grey matter (CORE) and the global myocardium (MORE) after breathing maneuvers were significantly reduced in patients when compared to healthy controls (mean CORE 0.29+/-0.63 vs. 1.083+/-0.5047, p = 0.0021, mean MORE 0.2497+/-3.495 vs. 4.451+/-4.15, p = 0.0131) (Fig 1). There is a significant correlation between CORE and LVEF in heart failure patients with a Pearson correlation coefficient r = 0.642, and a coefficient of determination r^2 = 0.4123, p=-0.032 (Fig 2). Conclusion: The significant reduction of both cerebral and myocardial oxygenation reserves in heart failure patients when compared to healthy control subjects indicated that microvascular dysfunction of both the cerebrum and myocardium are present in heart failure patients. The presence of a significant correlation between LVEF and CORE suggests that microvascular dysfunction in the brain may be a result of chronic hypoperfusion. Abstract 285 Figure. CORE and MORE Differences
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".