Left atrial cardiomyopathy detected by cardiac magnetic resonance in patients with left ventricular hypertrophy from different causes
Bibliographic record
Abstract
Abstract Background Left atrial (LA) late-gadolinium enhancement (LGE) can be easily detected by cardiac magnetic resonance (CMR). It may represent the structural substrate that promotes electrical and mechanical abnormalities in the setting of atrial cardiomyopathy. However, the prevalence of LA-LGE among patients with left ventricular hypertrophy (LVH) remains poorly defined. This study aimed to assess the prevalence of LA-LGE in this population Methods We evaluated patients referred for CMR at two centers due to an LVH phenotype, defined as an increased wall thickness >12mm. LA cardiomyopathy was diagnosed based on LA-LGE according to current recommendations on visual analysis. We divided the patients into three groups according to the cause of the left ventricle hypertrophy. Results A total of 99 patients were included with final CMR diagnoses of hypertrophic cardiomyopathy (HCM) in 48, infiltrative cardiomyopathy (IC) in 13, and hypertensive cardiomyopathy (HC) in 38. LA-LGE was present in 42 patients (41%). The prevalence of LA cardiomyopathy was significantly different by etiology: 45.8% in HCM, 92.3% in IC, and 21.1% in HC (p:0.0003). Age was significantly different between groups (51.3 vs 63.4 vs 59; p:0.002, respectively) and non-significant differences were found in other clinical features such as female sex, and body mass index. Furthermore, there were significant differences regarding LVEF (62.4% vs 47,8% vs 50.3%; p:<0.001), amount of LV-LGE (13% vs 23.2% vs 5.7%; p:0.001), maximal wall thickness (19.8mm vs 15.5mm vs 12.5mm; p:<0.001), and dynamic obstruction (15% vs 1% vs 0%; p: 0.003, respectively). There were no differences in LA dilation between the three groups (91.6% vs 100% vs 84.2%; p:0.22, respectively). Notably, LA-LGE was detected in 46.1% of patients with LA enlargement but also in 10% of those with normal LA size. Conclusions LA-LGE was highly prevalent among patients with different LVH etiologies, even in the absence of LA dilation, highlighting the need for heightened clinical suspicion to prevent underdiagnosis. These findings underscore the importance of incorporating advanced imaging techniques in the assessment of atrial remodeling in LVH phenotypes. Further studies are needed better to define its pathophysiological significance and potential prognostic implications.Characteristics of total population LA-LGE in LVH cardiomyopathies
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".