Prognostic Role of Right Atrial Reservoir Strain in Acute Heart Failure
Bibliographic record
Abstract
BACKGROUND: Right atrial (RA) dysfunction might indicate an advanced stage of heart failure (HF). The prognostic role of RA dysfunction, assessed according to RA reservoir strain (RArS), in hospitalized acute HF patients remains undetermined. METHODS: All consecutive patients hospitalized for acute HF were prospectively enrolled and had speckle-tracking echocardiography at discharge. The primary end point was all-cause mortality and HF rehospitalization. The patients were divided in 2 groups, on the basis of the RArS cutoff value derived from spline curve analysis. RESULTS: Of 401 patients (73.3 ± 12.1 years old; 60% male), 244 (55.1%) had RArS ≥ 11.4% and 177 (44.9%) had RArS < 11.4%. Worse left atrial and right ventricular (RV) function, larger RA size, and smaller left ventricular size were independently associated with RArS < 11.4%. During a median follow-up of 6 (interquartile range, 2.3-9.8) months, 141 (35.2%) patients reached the primary end point. Patients with RArS < 11.4% showed significantly higher percentage of cumulative events compared with patients with RArS ≥ 11.4% (49.2% vs 24.1%, respectively; log rank P < 0.001). Lower RArS was independently associated with the primary end point as a continuous (adjusted hazard ratio, 0.95 [95% confidence interval, 0.92-0.99]; P =0.006) and as a categorical (RArS <11.4%: adjusted hazard ratio, 1.80 [95% confidence interval, 1.05-3.08]; P = 0.032) variable. RArS provided incremental prognostic value over relevant clinical and echocardiographic variables including RV size, RV function, and RA size. CONCLUSIONS: Impaired RArS was independently associated with worse outcomes in hospitalized patients with acute HF. Its assessment before discharge could potentially allow refined risk stratification. CLINICAL TRIAL REGISTRATION: NCT05573997.
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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 | 0.000 |
| 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) | 0.001 | 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".