Comparison of Non‐Invasive Peripheral Vascular Function to Invasive Measures of Coronary Function in Patients with Suspected Coronary Microvascular Dysfunction
Bibliographic record
Abstract
Introduction The purpose of this study is to compare non‐invasive vascular assessments to invasive gold standard measures of coronary flow and resistance in patients with suspected coronary microvascular dysfunction (CMD), a condition driven by systemic endothelial dysfunction. We hypothesize that non‐invasive measures will be associated with both coronary flow and resistance following pharmacological hyperemia. Methods Forty‐one patients with suspected CMD attended the Cardiovascular Integrative Physiology Clinic at Southlake Regional Health Centre. Patients underwent finger‐based arterial tonometry (RHPAT) to non‐invasively quantify microvascular endothelial function (EndoPAT). A subset of participants (n=15) also concurrently completed flow mediated dilation (FMD) of the brachial artery to assess conduit artery endothelial function. Briefly, a standard blood pressure cuff was positioned on the right arm of patients, distal to the elbow joint. Baseline recordings preceded 5 minutes of forearm ischemia, and was followed by cuff deflation, eliciting reperfusion. Within 4 months, patients underwent coronary reactivity testing using the Doppler guidewire method. Specifically, the coronary flow reserve (CFR), and the index of microvascular resistance (IMR) were calculated during pharmacologically‐induced hyperemia using adenosine, then acetylcholine, then dobutamine. Prior to each stimuli, baseline measures were obtained to ensure hemodynamics results to baseline. Results RHPAT was negatively correlated to the IMR during dobutamine (r=−0.39, p=0.04), but not the CFR (r=0.14, p=0.49). FMD was negatively correlated to the IMR during adenosine (r=−0.64, p=0.01), but not the CFR (r=0.29, p=0.30). RHPAT and FMD were not correlated to the IMR or CFR during acetylcholine. Conclusion These preliminary results suggest that measures of non‐invasive peripheral vascular function can predict pharmacologically induced changes in coronary resistance, but not coronary flow. Support or Funding Information St. Jude Medical The Heart of Gold Cardiac Research Fund York University This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".