Análise da variabilidade de frequência cardíaca antes e durante o teste de inclinação em pacientes com síncope vasovagal com resposta cardioinibitória
Bibliographic record
Abstract
This dissertation states about the evaluation of the HRV through electrocardiographic Holter monitoring system before and during TT in patients with vasovagal syncope, with cardioinhibitory response, comparing it with HRV in patients with a negative response to tilt testing and without history of syncope.ere evaluated 64 patients (40 patients with and 24 patients without cardioinhibitory response with a negative response and no history of syncope, matched for age and sex) from January 2013 to February 2014. Datas clinical, on the classification score of Calgary and spectral analysis of HRV before and during TT were obtained. The mean age of patients was 36.2 years and 54.7% were male. The average number of episodes of syncope was 4.17 and the score was -0.9 Calgary. There were prodrome in 38 patients (95%) and the occurrence of trauma in eight patients (20%). In the case group, 21 patients (52.5%) showed response type IIa and 19 (47.5%) response type IIb, with no difference regarding age and sex. The median time to a positive TT response was 20.4 min, with a mean heart rate of 28.4 bpm and 14,2 of asystole. LF decreased and LF/HF ratio increased to the inclination (p=0.000 for both). Comparing the case and control groups, LF was higher value (11.62 vs 4.52 ms2, p=0.001) and LF/HF of less value in the supine position in the first group (3.92 vs 5,40ms2, p=0.008), with no difference during the TT. LF in the supine position was greater in the subgroup IIb (p=0.04), and there was no difference in other measures. Applying the operating characteristic curve, considering the variable stable cardioinhibitory, the areas under the curve were of 0.74 and 0.70, respectively, for the LF and the LF/HF ratio in the supine position (p=0.001 and 0.008, respectively). For the cutoff of 0.35 ms2 for LF, the sensitivity was 97.4% and specificity of 83.3% related to cardioinhibitory response. The positive predictive value (PPV) was 85.3% and the negative predictive value (NPV) was 96.9% and the positive likelihood ratio was 5.8. For the variable LF/HF ratio in supine position, the sensitivity was 89.7% and specificity of 66.7%, with a PPV of 72.9% and NPV of 86.6%.Spectral analysis in the supine position before tilt testing, through the BF and LF/HF ratio, allows one to identify patients with a history of syncope and cardioinhibitory response, with a high negative predictive value and likelihood ratio of 5.8 times.
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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 | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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 itClassification
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".