Moderated Posters: Congenital heart diseaseP374Classic-pattern dyssynchrony in adult patients with a Fontan circulationP375Outcome of pregnancy in patients with coarctation of aortaP376Diffuse myocardial fibrosis is not associated with decreased contractility: a magnetic resonance T1 mapping and feature tracking studyP377Cardiovascular abnormalities in patients with osteogenesis imperfecta: case-control studyP378Serial assessment of left ventricular systolic function by speckle tracking in patients with coarctation of the aorta undergoing stentingP379Longitudinal function and ventricular dyssynchrony are restored in children with pulmonary stenosis after percutaneous balloon pulmonary valvuloplastyP380Evaluation of the relationship between ventricular end-diastolic pressure and echocardiographic measures of cardiac function in adults with a Fontan circulationP381Right ventricular remodelling after percutaneaous pulmonary valve replacement in corrected tetralogy of Fallot with severe pulmonary regurgitation.Time matters
Bibliographic record
Abstract
Background: Fontan palliation has contributed to a growing adult population with univentricular hearts (UVH). However, patients with UVH often suffer from progressive heart failure and arrhythmias leading to transplantation or death. Some previous studies on children have suggested the presence of dyssynchrony in different UVH morphologies. Purpose: Since cardiac resynchronization therapy (CRT) might be an effective treatment in carefully selected patients, we investigated the presence of classic-pattern dyssynchrony (CPD) and its relation to increased QRS duration and association with systolic and diastolic dysfunction. Methods: In a retrospective cross-sectional study, we investigated 101 adult patients with Fontan circulation. By post-processing a short axis and long-axis 2D images we generated strain curves that were visually assessed for the presence of early and late activated deformation, if the typical activation pattern was present patients were assigned to CPD group. Peak systolic strain, diastolic strain-rate (SR), and mean tissue velocities were automatically extracted from the strain-and displacement curves. Cardiac ultrasound images of 99 age-and gender matched control subjects were analyzed in the same way. Results: 101 patients were included at an mean age of 21, range 14-59 years and 60% were male, with differing anatomic lesions: unbalanced AV-canal (n19), hypoplastic left heart syndrome (n15), tricuspid atresia (n23), double inlet left ventricle (n21), single ventricles and others (n23). Eighteen of 101 Fontan-palliated patients had CPD. A high percentage (47%) of patients with unbalanced AV-canal displayed CPD, mostly with prolonged QRS, while the number of CPD in RV (9%) and LV (12%) anatomy was lower (p0.016), with still a significant number (18%). Only six patients out of 18 with CPD had a ventricular pacemaker with predominant ventricular pacing. Four patients with ventricular pacing showed neither CPD nor a widened QRS. CPD ventricles (n18), compared to other Fontan-palliated patients (n83) and healthy controls displayed significantly larger QRS width (143619 vs 107 616 vs 87 612 ms), lower EF (30613 vs 46613 vs 5568% p<0.05), lower early diastolic SR (0.760.5 vs1.260.8 vs 1.760.5s-1), systolic circumferential (-965 vs-1667 vs -2264%) and longitudinal strain (-865 vs -14 65 vs -196% p<0.05), respectively. Conclusion: CPD is present in a significant percentage of adults with Fontan palliation. CPD ventricles have reduced systolic and diastolic function compared to other Fontan-palliated patients. Since the presence of CPD predicts response to CRT in normal biventricular circulation, our findings might have important potential implications for prospective evaluation of CRT in this specific patient-population.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".