Abstract 4146349: Coronary atheroma burden and structural vascular dysfunction in women with suspected ischemia and no obstructive coronary artery disease.
Bibliographic record
Abstract
Background: Different mechanisms have been proposed to explain abnormal coronary flow reserve (CFR), with authors describing structural vs functional endotypes of coronary microvascular dysfunction (CMD). Epicardial coronary atheroma burden (AB) index is a marker of vascular remodeling confirmed by intravascular ultrasound and is estimated by the measurement of coronary artery tapering. Atheroma burden index is inversely related to CFR in women with suspected ischemia and no obstructive coronary artery disease (INOCA). We hypothesized that AB could help better understand the pathophysiology of these CMD endotypes. Purpose: To evaluate the association between epicardial AB, baseline average peak velocity (APV), and resting coronary blood flow (CBF) to better understand endotypes (structural vs functional) of vascular dysfunction. Methods: Women with suspected INOCA (n=180) enrolled in two prospective cohort studies (NCT02582021, NCT03876223) who underwent clinically indicated invasive coronary function testing with a Doppler wire measuring CFR, baseline APV and resting CBF, were included in this analysis. Epicardial AB was measured by core laboratory and was derived for the left main and anterior descending coronary segments. The association of AB with CBF and APV was assessed using Pearson’s correlation coefficient. Results: Mean age was 55±10 years, body mass index 27.5±5.9 kg/m 2 , 33% had hypertension, 12% diabetes, 18% dyslipidemia and 27% were former smokers. Mean average AB was 1.33±0.37, mean maximal AB was 2.02±0.54 and mean CFR was 3.23±2.35. Both average and maximal AB negatively correlated with resting CBF (r=-0.23, p=0.005; and r=-0.20, p=0.015, respectively) and positively correlated with baseline APV (r=0.23, p=0.002; and r=0.18, p=0.015, respectively). (Figure) Conclusions: These results suggest that the findings of a low resting CBF and high baseline APV, among women with suspected INOCA, is associated with a higher epicardial coronary AB. The use of baseline APV and resting CBF could help identify those who are affected by a structural endotype of coronary vascular dysfunction.
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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".