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Record W7117580543 · doi:10.1016/j.trsl.2025.12.007

Predicting exercise pulmonary hypertension: the right-net machine learning model a pilot study

2025· article· en· W7117580543 on OpenAlex
Francesco Ferrara, Rossana Castaldo, Luna Gargani, Nicola Benjamin, Andreina Carbone, Erberto Carluccio, Antonio Cittadini, Veronica Codullo, Anna D’Agostino, Michele D’Alto, Ekkehard Grünig, Andrea Esposito, Giovanni Esposito, Stefano Ghio, Jaroslaw D. Kasprzak, Graziella Lacava, Alberto M. Marra, Marco Matucci-Cerinic, Antonella Moreo, Eugenio Picano, Salvatore Rega, Andrea Soricelli, Karina Wierzbowska‐Drabik, R. Naeije, Eduardo Bossone, Monica Franzese

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.

fundA Canadian funder is recorded on the work.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueTranslational research · 2025
Typearticle
Languageen
FieldMedicine
TopicCardiovascular and exercise physiology
Canadian institutionsnot available
FundersUniversitatea de Medicină, Farmacie, Științe și Tehnologie din Târgu MureșMinistero della SaluteMcGill University
KeywordsPhysical activityPredictive modellingExercise physiologyRisk assessment

Abstract

fetched live from OpenAlex

BACKGROUND: Exercise-transthoracic Doppler echocardiography (Ex-TTE) determination of mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope may offer key diagnostic and prognostic information in cardiorespiratory diseases. However, its applicability and reliability in routine clinical practice remain to be established. Herein, the aim of the present study was to apply a machine learning (ML) model to predict abnormal exercise TTE-derived mPAP/CO slope (>3 mmHg/L·min) in individuals at risk of pulmonary hypertension (PH), based only on clinical and resting TTE parameters. METHODS: The study population (221 healthy adults and 196 patients with connective tissue disease) was grouped according to mPAP/CO slope ≤3 vs. >3 mmHg/L·min (n = 222 and n = 195, respectively). Three different ML models (Elastic Net-Regularized Generalized Linear Model, Classification and Regression Tree, LogitBoost) were trained on resting clinical and TTE parameters to predict mPAP/CO slope >3 mmHg/L·min. Data were split into training/test sets to evaluate performance. The model with the highest area under the curve (AUC) on the test set was selected. RESULTS: The Elastic Net model achieved the best performance (AUC=0.92). Lower tricuspid annular plane systolic excursion/systolic PAP ratio, female sex, and smaller left ventricular outflow tract diameter were the key features predicting TTE-derived mPAP/CO slope >3 mmHg/L·min. CONCLUSIONS: An ML algorithm using resting clinical and TTE parameters can effectively predict exercise TTE-derived mPAP/CO slope >3 mmHg/L·min, supporting its use as a noninvasive tool to identify individuals at risk of exercise PH.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Simulation or modeling · Consensus signal: Simulation or modeling
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.483
Threshold uncertainty score0.490

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.093
GPT teacher head0.363
Teacher spread0.270 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it