Classic pattern dyssynchrony predicting outcome in patients with Fontan circulation
Bibliographic record
Abstract
Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Helse Nord, Norway Background Morbidity and mortality increase as Fontan patients age into adulthood. Limited studies have examined cardiac magnetic resonance and echocardiographic parameters to predict death and transplantation in children after Fontan operation. Purpose The aim of the study was to investigate echocardiographic parameters in adolescents and adults after Fontan operation including myocardial mechanics including classic pattern dyssynchrony (CPD) as predictors of transplantation or death. Methods In a cross-sectional retrospective study, strain analysis was performed on echocardiography studies performed between 2001 and 2014 of 110 patients with single ventricle physiology after the Fontan procedure. Strain curves were measured and visually assessed for the presence of CPD. The primary end point was death or transplantation after a follow-up period of 85 ± 35 months after echocardiography. Results Median age at date of echocardiography was 20, range 3 to 45 years. Of 110 patients 28 patients were transplanted. During the study-period 3 patients died after transplantation and 7 patients died without being transplanted. CPD was seen in 16 and protein losing enteropathy (PLE) in 21 of 110 patients. By multivariate-analysis, CPD (HR 9.4 CI 2.6-34.6), PLE (HR 10.6 CI 3.4-33.2); systolic blood pressure (HR 0.954 CI 0.913-0.996), systolic/diastolic duration ratio (HR 6.83 CI 1.33-35.0) and E wave deceleration time (HR 0.98 CI 0.97 - 0.99) were independently associated with the primary end point. Conclusion CPD, PLE, systolic and diastolic ventricular dysfunction are significantly associated with transplantation or death in Fontan operated patients. In selected patients, the presence of CPD may be a basis to investigate cardiac resynchronization therapy as a treatment strategy. Abstract Figure: Mortality in patients with CPD
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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 | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 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".