Electrocardiographic Findings in Genotype-Positive and Non-Sarcomeric Children with Definite Hypertrophic Cardiomyopathy and Subclinical Variant Carriers.
Bibliographic record
Abstract
Abstract Background In children with hypertrophic cardiomyopathy (HCM), the genotype-phenotype association of abnormal electrocardiographic (ECG) features in the backdrop of gene positivity have not been well described. This study aimed to describe abnormal ECG findings in children with HCM harboring genetic variants and determine the association with Major Adverse Cardiac Events (MACE). Methods We retrospectively analyzed 81 variants positive, phenotype positive (V+P+), 66 variant positive, phenotype negative (V+P-), and 85 non-sarcomeric subjects. We analyzed ECG findings and clinical outcomes in these three groups. Results Combined ST and T wave changes and pathologic Q waves were the most common abnormalities in variant and non-sarcomeric subjects. The V+P+ group showed higher occurrence of ST segment changes and T wave abnormalities compared to V+P- group. Independent predictors of MACE included ST segment changes, (OR=3.54, CI= 1.20-10.47, p=0.022). T wave changes alone did not predict outcome (OR=2.13, CI= 0.75-6.07, p=0.157), but combined repolarization abnormalities (ST+T changes) were strong predictors of MACE (OR= 5.84, CI=1.43-23.7, p=0.014) than ST segment changes alone. Maximal wall z-score by echocardiography was a predictor of MACE (OR=1.21, CI=1.07-1.37, p=0.002). Despite significant myocardial hypertrophy (z score>4.7), voltage criteria for LVH were much less predictive. In the non-sarcomeric group, RVH was significantly associated with MACE (OR=3.85, CI= 1.08-13.73, p= 0.038). Conclusion Abnormal ECG findings described in subjects with known genetic status and myocardial hypertrophy, may add incremental value to the diagnosis and surveillance of disease progression in children with HCM. Select ECG findings, particularly repolarization abnormalities, may serve as predictors of MACE.
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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 | 0.001 |
| 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".