Abstract 12378: Association of Hypertensive Disorders of Pregnancy With Coronary Microvascular Dysfunction 8-10 Years After Delivery
Bibliographic record
Abstract
Introduction: Hypertensive disorders of pregnancy ( HDP ) are associated with subsequent adverse cardiac remodeling and cardiovascular disease ( CVD ). The pathophysiologic mechanisms linking HDP to CVD, including the role of myocardial microvascular disease, are understudied. Hypothesis: Individuals with HDP history will have abnormal microvascular coronary flow reserve ( CFR ) 8-10 years after delivery and abnormal CFR will correlate with left ventricular ( LV ) remodeling. Methods: Individuals with pregnancies delivered 2008-2010 underwent burst-replenishment myocardial contrast echocardiography (2017-2020) to quantify myocardial perfusion at rest and during dobutamine stress. Video intensity vs. time data were used to derive β, the rate of rise of video intensity, a correlate for myocardial blood flow. CFR was calculated as the ratio of β at peak stress to β at rest, averaged across LV myocardial regions of interest. Results: We studied 91 individuals (age 38±6, 9.1±0.9 years post-delivery), 19 with a history of HDP). Individuals with abnormal CFR (β ratio <2.0, n=13) had higher pre-pregnancy BMI, baseline heart rate, hemoglobin A1c, and a history of HDP (46.2% vs 16.7%; p =0.026). Association of CFR and HDP was attenuated after adjusting for pre-pregnancy BMI and hemoglobin A1c ( p =0.114). In exploratory subgroup analyses, individuals with both LV remodeling (relative wall thickness>0.42) and HDP had the highest proportion of microvascular dysfunction (41.7% vs. +HDP-LV remodeling 14.3%, -HDP+LV remodeling 7.7%; p =0.0498). Conclusions: Individuals with HDP history may be more likely to have coronary microvascular dysfunction one decade after delivery. Larger studies are needed to determine if microvascular dysfunction may be a mechanism for development of CVD among individuals with HDP.
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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 | 0.000 | 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) | 0.003 | 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".