Coronary microvascular dysfunction and right ventricular structure and function
Bibliographic record
Abstract
Abstract: Previous studies have suggested associations between coronary microvascular dysfunction (CMD) and alterations in left ventricular (LV) structure and function Data are however scarce regarding the right ventricular (RV). In the context of CMD, the RV could be affected via mechanisms potentially involving ischemia from CMD, shared pathophysiological milieu leading to adverse ventricular remodeling, and/or increased afterload secondary to increased LV end-diastolic pressure or heart failure with preserved ejection fraction (HFpEF) with pulmonary hypertension. We evaluated the relationship between measures of RV structure/function and invasively measured CMD in individuals with suspected ischemia and no obstructive coronary artery (INOCA) disease. We included 297 participants from the WISE-HFpEF, WISE-preHFpEF and WISE-CVD cohorts, who underwent cardiac magnetic resonance imaging (CMRI) and coronary function testing to measure coronary flow reserve (CFR) in response to adenosine and coronary blood flow change in response to acetylcholine (∆CBF). We assessed the correlation between RV parameters on CMRI and coronary microvascular function (CFR and ∆CBF). Participants had a mean age 54±11 years. Of them, 104 (39%) had hypertension, 31 (11%) had diabetes, and 18 (7%) had chronic obstructive pulmonary disease. Mean RV end-diastolic volume was 66.6±11.0 mL/m2, RV ejection fraction was 62.7%±5.6% and RV longitudinal strain was −27.2%±3.5%. We found no significant correlation between RV parameters and coronary microvascular function. This is the first study to report associations between invasively measured CMD and CMRI parameters of RV structure and function among patients with suspected INOCA. Despite a large sample size, we found no significant relationship between RV structure or function and CMD. These results suggest that RV abnormalities do not precede and are not concurrent with CMD in suspected INOCA participants. Longitudinal prospective studies are needed to evaluate if RV deterioration may occur later during the course of CMD and among patients with HFpEF.
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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 | 0.001 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".