Abstract 4144410: Mechanical Complications in Hemorrhagic Myocardial Infarction: Insights from Wall Strain Index Ratio for Predicting Cardiac Rupture (MIRON-STRAIN)
Bibliographic record
Abstract
Background: Mechanical complications following Myocardial Infarction (MI), such as ventricular rupture, significantly impact patient morbidity and mortality. Reperfused MI characterized by intramyocardial hemorrhage (hMI), has been identified to be the most severe form of myocardial injury. However, whether hMI portends a higher risk for mechanical complications is not known. The Wall Strain Index (WSI) Ratio, which is a measure of myocardial deformation and one that has been previously validated for cardiac rupture, is a desirable biomarker for examining the potential mechanical differences in strain development in hMI vs. non-hMI. Research Question: Do patients with hMIs have a higher radial and circumferential Wall Strain Index (WSI) Ratio compared to patients without hMI? Methods: We performed a retrospective cohort study (MIRON-STRAIN, NCT06450912) in mechanically revascularized STEMI patients (n=181) who underwent CMR (cine, T2* and LGE) approximately 2 days after PCI. WSI Ratio was computed using the 2D-strain module in CVI 42 (circumferential&longitudinal). Parametric statistics was performed using Shapiro-Wilk test and non-parametric statistics was performed using Mann-Whitney U test. Results: Patients with hMI (n=104) showed significantly higher radial and circumferential WSI Ratios compared to non-hMI patients. The radial WSI Ratio was approximately 58% higher in hMI relative to non-hMI patients (1.36±0.72 in hMI vs. 0.86±0.55 in non-hMI (p<0.001)). The circumferential WSI Ratio was 103% higher in hMI patients compared to those with non-hMI (1.22±0.87 in hMI vs. 0.60±0.44 in non-hMI (p<0.001)). Median and IQR values for radial and circumferential WSI ratios showed significant differences, indicating the development of higher myocardial stress in hMI. Additional findings in hMI included higher LV EDV (122.08±33.22 ml vs. 100.78±31.92 ml, p<0.001), and Infarct Size (%LV, 38.69±14.27% vs. 16.20±12.11%, p<0.001). Conclusion: The Wall Strain Index Ratio is significantly elevated in hMI patients, indicating hMI patients carry a significant risk for mechanical complications. Our findings suggest that WSI Ratio can serve as a valuable biomarker for enabling timely and targeted monitoring and critical care.
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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 | 0.000 | 0.000 |
| 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 | 0.000 |
| 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".