Abstract 2915: Circulating Fas in Subjects with Acute Cardiomyopathy and Myocarditis: Results from IMAC 1
Bibliographic record
Abstract
Introduction In acute cardiomyopathy (ACM), lower myocardial Fas expression is predictive of greater LV recovery during follow up. Whether circulating Fas reflects myocardial activity and predicts recovery is unknown. We examined the predictive value of serum Fas, and its correlation with myocardial expression in subjects in the multicenter IMAC 1 (Intervention in Myocarditis and Acute Cardiomyopathy) trial. Methods Sixty-two subjects with recent onset dilated CM were enrolled in the IMAC 1 trial between 1996 and 1999. Plasma TNF, soluble TNF receptors 1 and 2, and serum Fas were measured (via ELISA) at entry in 56 subjects. In 20 subjects, myocardial expression of Fas was assessed by RNAse protection assay (RPA). Improvement in LVEF was assessed by radionuclide angiography at 6 and 12 months, and subjects were followed prospectively for up to 3 years. The correlation of serum Fas to circulating TNF and TNFR, and to myocardial Fas was assessed. The predictive value of serum Fas was assessed by comparison of Fas tertiles. Results The cohort (37M/25F, entry LVEF 0.25 ± 0.08, age 43 ± 12) had a mean serum Fas of 2.6 ± 1.4 ng/ml. Higher NYHA class was associated with higher Fas level (ng/ml): I/II/III/IV=2.4 ± 1.0/2.4 ± 1.1/2.7 ± 1.0/4.1 ± 2.9, p=0.035). Serum Fas demonstrated no correlation with myocardial Fas expression (r=0.169, p=0.50), but was tightly correlated with plasma TNF (r=0.75, p=0.001), TNFRI (r=0.73, p=0.001) and TNFRII (r=0.75, p=0.001). Examination of serum Fas tertiles demonstrate that low Fas was associated with higher RVEF at entry (0.39 ± 0.12 versus 0.31 ± 0.10, p=0.04), but not baseline LVEF (0.25 ± 0.08 versus 0.25 ± 0.09, p=0.97). Low Fas was associated with a trend toward higher improvement in LVEF at 12 months (change LVEF=0.19 ± 0.11, versus 0.12 ± 0.14, p=0.10) which failed to reach significance. Event free survival was similar in the low serum Fas and higher Fas tertiles (p=0.78). Conclusion Serum Fas was strongly correlated with plasma cytokines (TNF, TNFRI and TNFRII), NYHA class and RVEF. Serum Fas was not correlated with myocardial Fas, and Fas tertiles did not predict subsequent improved LVEF or event free survival. In ACM, serum Fas may reflect systemic peripheral inflammation rather than myocardial processes.
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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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".