The Use of Ambulatory Blood Pressure Monitoring in Pediatric Heart Transplant Recipients
Bibliographic record
Abstract
BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is the gold-standard non-invasive test for diagnosing arterial hypertension; however, it remains understudied in pediatric heart transplant recipients (HTRs). We evaluated the role of ABPM in diagnosing and managing hypertension. METHODS: We conducted a single-center retrospective evaluation of pediatric HTRs transplanted between 2010 and 2023 (inclusive) with ≥ 1 post-transplant ABPM. Clinic blood pressures (CBPs) temporally linked to each ABPM were used to categorize patients into blood pressure phenotypes: normotensive (including well-controlled hypertension, if on anti-hypertensive therapy), sustained, white coat (WCH), and masked hypertension (MH). Demographic, clinical, and echocardiographic characteristics were compared across hypertensive phenotypes, with longitudinal changes evaluated using serial ABPMs. RESULTS: Data were available for 33 pediatric HTRs (61% female [20/33], median age at first ABPM 7.3 [5.3-10.4] years, 0.7 [0.2-2.6] years post-transplant). At the initial ABPM, 82% (27/33) were normotensive and 18% (6/33) were hypertensive, with 79% (26/33) on ≥ 1 antihypertensive medication. Of those with hypertensive CBPs, 60% (6/10) had a normal ABPM indicating WCH. At subsequent ABPM, 48% (10/21) normotensive patients remained normotensive, while 43% (9/21) developed hypertension. Among the 6 patients with WCH, 5 (83%) developed subsequent hypertension by ABPM. Median left ventricular mass was higher in hypertensive patients (160.9 g, 64.3-172.3 g) compared with WCH (54.4 g, 36.9-100.7 g) and normotensive patients (66.9 g, 45.4-94.3 g) (p = 0.032). CONCLUSIONS: ABPM provides important hypertension insights for pediatric HTRs, especially with abnormal CBPs. Progression from WCH to manifest hypertension was common. ABPM should therefore be utilized prior to implementing or modifying anti-hypertensive therapy.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".