Post-valvular energy exchange in bicuspid aortic valve with regurgitation and stenosis and its association with left ventricular workload: a 4D flow magnetic resonance imaging cross-sectional study
Classification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Bicuspid aortic valve (BAV) regurgitation and stenosis considerably alter post-valvular flow dynamics and impose additional energetic load on the left ventricle (LV). We therefore sought to determine whether 4D Flow MRI-derived ascending-aortic kinetic energy (KE) and viscous energy loss (EL), can differentiate BAV subtypes and healthy controls, and are associated with LV remodeling markers. METHODS: Seventy-one participants (19 BAV without valve dysfunction, 17 with isolated aortic regurgitation (BAV-AR), 15 with isolated aortic stenosis (BAV-AS), and 20 healthy controls) underwent 3.0 T magnetic resonance imaging (MRI), including cine balanced SSFP and 4D-Flow. Post valvular KE, viscous EL, and the dimensionless EL index were computed from the 4D Flow velocity fields. Global 3D LV strain metrics were derived via cine SSFP feature-tracking technique. Between-group differences were assessed with one-way ANOVA or Kruskal-Wallis tests, and associations were evaluated using Spearman's rank correlation. RESULTS: Average ascending aortic KE rose progressively from controls (3.3[2.3-4.3]) to uncomplicated BAV (6.7[5.3-9.1]), to BAV-AS (15.4[12.2-29.5]) and peaked in the BAV-AR (19.4[14.9-21.3], p < 0.001). Peak-systolic viscous EL was significantly elevated in both the stenotic (16.2 [9.1-24.4] mW) and regurgitant (11.4 [9.5-17.6] mW) groups compared to controls (4.1 [3.4-5.7] mW), but not in the uncomplicated BAV (6.4 [5.1-8.0] mW). Over the entire systole, viscous EL in the uncomplicated BAV (3.3 [2.5-4.1] mW) was also statistically increased compared to controls (1.7 [1.3-2.3] mW). KE correlated more strongly with regurgitation severity (rho = 0.50, p < 0.001), and EL with stenosis severity (rho = 0.48, p < 0.001). Aortic surgery referral was more closely associated with elevated KE (rho = 0.65, p < 0.001) and viscous EL (rho = 0.64, p < 0.001) than with aortic diameter (rho = 0.50, p < 0.001). Left ventricular Mass index and peak diastolic strain rate circumferential were correlated but more strongly with KE than viscous EL. CONCLUSIONS: 4D Flow MRI-derived post-valvular KE and viscous EL may serve as sensitive early biomarkers of LV dysfunction, and might outperform aortic diameter in risk stratification, and guide optimal intervention timing in BAV diseases while they need to be validated in broader populations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 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) | 0.000 | 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 it