PS-BPC05-4: DIASTOLIC FUNCTION AND STROKE VOLUME MEASURED BY ECHOCARDIOGRAPHY IS RELATED TO PROGRESSION OF FRAILTY IN ELDERLY HYPERTENSIVE OUTPATIENTS
Bibliographic record
Abstract
Objective: In hypertensive patients, echocardiographic measures of cardiac structure and function were related to cognitive dysfunction and frailty in cross sectional studies; however, longitudinal relationship of these parameters has not been elucidated. We investigated whether stroke volume and diastolic function in echocardiography was predictive of worsening of cognitive function and frailty for 3 years. Design and Methods: Among 330 hypertensive patients who were registered in the frailty clinic and underwent echocardiography, 93 patients were followed up for 3 years. We evaluated stroke volume and diastolic function in echocardiography, frailty status evaluated as Kihon checklist (KCL), and cognitive function measured as mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA). Results: Patients’ mean age was 78.8 ± 7.1 years old (58% male). KCL score remained or decreased in 50 (54 %) patients after 3 years of follow up (7.1 ± 4.7 points to 5.7 ± 4.7), and increased in 43 (46 %) patients (6.1 ± 4.1 to 8.9 ± 4.4). Between those whose KCL score increased and remained or decreased, there were no statistical difference in history of hypertension, heart failure, diabetes mellitus, stroke and type of antihypertensives; however, MMSE and MoCA score at follow up was higher in patients whose KCL score remained or decreased (MMSE: 27.8 ± 2.5 vs 26.7 ± 3.3, p = 0.24, MoCA: 22.2 ± 4.0 vs 20.7 ± 5.2, p¬ = 0.036). Ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e’) at baseline was lower in patients whose KCL score remained or decreased (E/e’ septal 11.8 ± 3.0 vs 14.4 ± 5.5 p = 0.01). Other value for diastolic function was not related to the change of KCL score. Logistic regression analysis revealed E/e’ septal was independently associated with an increased KCL score even after adjusting for age, sex, BMI, history of hypertension, diabetes mellitus, heart failure, and KCL score at baseline (p = 0.036, odds ratio = 0.89). On the other hand, E/e’ was not significantly different in the parallel analysis according to domains of physical function, nutritional state, cognitive function, and depressive mood in KCL. Systolic volume in echocardiography at baseline was related to change in physical function in KCL at follow up (r = -0.226, p = 0.028). Conclusions: E/e’ in echocardiography at baseline was predictive of worsening of frailty status, measured as KCL score, at 3 years later.
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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 | 0.002 |
| 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 | 0.001 |
| 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".