Abstract P296: Poor Functional Capacity is Associated With Peripheral Microvascular Dysfunction in Coronary Artery Disease
Bibliographic record
Abstract
Introduction: Reduced functional capacity, assessed by self-reported Duke Activity Status Index (DASI) is associated with adverse outcomes. Peripheral microvascular dysfunction, measured as reduced digital reactive hyperemia index (RHI) is also associated with adverse events. Whether microvascular dysfunction is related to functional capacity is unknown. Hypothesis: We hypothesized that peripheral microvascular dysfunction is associated with diminished functional capacity. Methods: In 531 patients with stable CAD (age 62±9, 75% male, 30% Black, EF 55±13%) enrolled in the Mental Ischemia Prognosis Study, self-reported functional capacity was assessed with the DASI questionnaire with a score of >25 as the cutoff for normal. Pulsatile arterial tonometry (EndoPat, Itamar Inc.) was used to measure digital RHI during 5 minutes of upper arm occlusion with blood pressure cuff followed by reperfusion. Logistic regression was used to model reduced RHI ( 25 vs ≤ 25). Results: Median RHI was 2.01 [IQR 1.67, 2.49] while median DASI score was 45 [29,53], equivalent to 8.3 METs. Compared to those with normal DASI score (>25; N=425), subjects with low DASI score (≤25; N=106) had lower RHI (1.88 [1.64, 2.24] vs 2.06 [1.69, 2.54], P=0.048), higher BMI (32±7 kg/m 2 vs 29±5 kg/m 2 , P<0.001), were more likely to be female (48% vs 20%, P<0.001) and Black (42% vs 28%, P=0.005), and more likely to have a history of hypertension (87% vs 75%, P=0.009), diabetes (39% vs 29%, P=0.046), and heart failure (34% vs. 20%, P=0.003). After adjusting for the aforementioned variables in addition to history of dyslipidemia, smoking and prior MI, those with a low DASI score had a significantly higher likelihood of a reduced RHI ( Conclusion: Poor functional capacity is independently associated with microvascular dysfunction in patients with stable CAD, and illustrates a potential mechanism by which reduced functional capacity increases cardiovascular risk. Whether improvement in functional capacity by exercise/rehabilitation programs improves microvascular function requires further investigation.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 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".