Abstract 16529: Frailty in Fontan Patients - A Sign of Premature Aging?
Bibliographic record
Abstract
Introduction: Patients submitted to a Fontan operation sustain a lifelong state of reduced cardiac output and increased venous pressure potentially inducing premature aging. We hypothesize that Fontan patients, despite their young age, resemble more elderly patients compared to age-matched controls. Methods: At a tertiary care center, we evaluated 17 Fontan patients who had a recent abdominal CT scan for Fontan associated liver disease follow-up. Psoas muscle area (PMA), a recognized marker of frailty, was measured on the axial plane at the level of L4. The distributions of PMA scores were compared between Fontan and 1) patients undergoing a transcatheter aortic valve replacement (TAVR); and 2) an age-matched healthy cohort, separately with Kruskal-Wallis test. Results: The Fontan group comprised six males and 11 females aged 19-40. The proportions of systemic left ventricle and heterotaxy syndrome were 82% and 18% respectively in females and 33% and 33% respectively in males. The TAVR cohort included 241 males and 184 females aged 70-99. The healthy cohort enrolled 59 males and 66 females age-matched to the Fontan group. Among the Fontan patients, median and interquartile range of PMA were 18.1, 14.85-21.12 cm2 in females and 23.41, 22.25-30.21 cm2 in males. The comparison between the groups for males (Panel A) and females (Panel B) are illustrated in the Figure. Conclusions: Males Fontan appear to have reduced muscle mass that resembles more patients who are candidates for TAVR than aged-matched controls, an observation that, interestingly, was not seen in females in this small well-characterized cohort. To our knowledge, this is the first study to document a direct comparison of Fontan patients to other subgroups illustrating a mismatch between chronological and biological age in Fontan. Further studies are needed to elucidate the possible protective effect of female sex.
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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) | 0.003 | 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".