Adaptation of Left Ventricular Function and Myocardial Microstructure in Fetuses With Right Ventricular Hypoplasia
Bibliographic record
Abstract
BACKGROUND: In this study we evaluated changes in left ventricular (LV) function and myocardial microstructure in fetuses with right ventricular hypoplasia (RVH) using 2-dimensional speckle tracking echocardiography, diffusion tensor cardiovascular magnetic resonance imaging, and proteomics analysis. METHODS: Fifty-one singleton fetuses diagnosed with RVH and 51 normal fetuses were retrospectively included. LV global longitudinal strain and global circumferential strain were acquired using 2-dimensional speckle tracking echocardiography. Fraction anisotropy, mean diffusivity, and helix angle were measured using diffusion tensor cardiovascular magnetic resonance imaging in 4 fetal specimens with RVH and 3 normal fetal specimens. Bioinformatics analysis was performed for differentially expressed proteins between RVH and normal specimens. RESULTS: In RVH fetuses, LV global longitudinal strain and regional longitudinal strain were significantly lower than in controls (P < 0.001), whereas LV sphericity index and LV global circumferential strain were increased. In RVH fetuses, fraction anisotropy was higher in middle and apical segments than in normal fetuses (P < 0.001). LV mean diffusivity was reduced in all of the segments (P < 0.001). Circumferentially oriented myocytes and left-handed oriented myocytes were increased, but right-handed oriented myocytes were decreased (P < 0.001). Using proteomics, 95 myocardial proteins differed with upregulation of 66 and downregulation in RVH hearts including myocardial contractile fibrillar proteins and cell membrane protein complexes. CONCLUSIONS: In fetal RVH, the left ventricle demonstrates altered function with reduced longitudinal but augmented circumferential strain, which might support its need to augment its preload and consequent cardiac output. Decreased right-handed and increased circumferentially oriented myocytes might contribute to this adaptation. The left ventricle in fetal RVH also demonstrates a differential expression of various myocardial proteins.
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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 | 0.001 |
| 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".