Pulmonary Arterial Hypertension and Left Heart Disease Phenotype: A Challenging Crossroad
Bibliographic record
Abstract
Although pulmonary arterial hypertension (PAH) usually affects young people with a low burden of cardiovascular comorbidities, epidemiologic changes over time have been providing a codified phenotype of subjects with PAH, characterized by a hemodynamic profile compatible with pure pre-capillary pulmonary hypertension (PH), associated with increased risk factors for left heart disease (LHD). Compared with the younger subjects belonging to the classical PAH phenotype, those with PAH and LHD phenotype share several distinctive features. They include: 1) the older mean age at diagnosis of PAH; 2) peculiar hemodynamic features, characterized by a trend toward lower values of mean pulmonary arterial pressure and pulmonary vascular resistances, and higher values of pulmonary artery wedge pressure; 3) greater clinical deterioration; 4) more impaired exercise capacity; 5) higher mortality risk; 6) weaker response to PAH-targeted treatment; and 7) higher rate of PAH drug discontinuation. Physicians must be aware of such peculiar phenotype of PAH. This is advisable for providing a comprehensive diagnostic workup, in order to reduce the risk of PH misclassification and provide the most appropriate decision-making approach.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".