A deep patient-similarity learning framework for the assessment of diastolic dysfunction in elderly patients.

Aims: Age-related changes in cardiac structure and function are well recognized and make the clinical determination of abnormal left ventricular (LV) diastolic dysfunction (LVDD) particularly challenging in the elderly. We investigated whether a deep neural network (DeepNN) model of LVDD, previously validated in a younger cohort, can be implemented in an older population to predict incident heart failure (HF).

Methods And Results: A previously developed DeepNN was tested on 5596 older participants (66-90 years; 57% female; 20% Black) from the Atherosclerosis Risk in Communities Study.

Electrocardiogram-Based Machine Learning Emulator Model for Predicting Novel Echocardiography-Derived Phenogroups for Cardiac Risk-Stratification: A Prospective Multicenter Cohort Study.

Purpose: Electrocardiography (ECG)-derived machine learning models can predict echocardiography (echo)-derived indices of systolic or diastolic function. However, systolic and diastolic dysfunction frequently coexists, which necessitates an integrated assessment for optimal risk-stratification. We explored an ECG-derived model that emulates an echo-derived model that combines multiple parameters for identifying patient phenogroups at risk for major adverse cardiac events (MACE).

High Prevalence of Pericardial Involvement in College Student Athletes Recovering From COVID-19.

Objectives: This study sought to explore the spectrum of cardiac abnormalities in student athletes who returned to university campus in July 2020 with uncomplicated coronavirus disease 2019 (COVID-19).

Background: There is limited information on cardiovascular involvement in young individuals with mild or asymptomatic COVID-19.

Methods: Screening echocardiograms were performed in 54 consecutive student athletes (mean age 19 years; 85% male) who had positive results of reverse transcription polymerase chain reaction nasal swab testing of the upper respiratory tract or immunoglobulin G antibodies against severe acute respiratory syndrome coronavirus type 2.

Prediction of coronary artery calcium scoring from surface electrocardiogram in atherosclerotic cardiovascular disease: a pilot study.

Aims: Coronary artery calcium (CAC) scoring is an established tool for cardiovascular risk stratification. However, the lack of widespread availability and concerns about radiation exposure have limited the universal clinical utilization of CAC. In this study, we sought to explore whether machine learning (ML) approaches can aid cardiovascular risk stratification by predicting guideline recommended CAC score categories from clinical features and surface electrocardiograms.

Machine Learning Assessment of Left Ventricular Diastolic Function Based on Electrocardiographic Features.

Background: Left ventricular (LV) diastolic dysfunction is recognized as playing a major role in the pathophysiology of heart failure; however, clinical tools for identifying diastolic dysfunction before echocardiography remain imprecise.

Objectives: This study sought to develop machine-learning models that quantitatively estimate myocardial relaxation using clinical and electrocardiography (ECG) variables as a first step in the detection of LV diastolic dysfunction.

Methods: A multicenter prospective study was conducted at 4 institutions in North America enrolling a total of 1,202 subjects.

A Network-Based "Phenomics" Approach for Discovering Patient Subtypes From High-Throughput Cardiac Imaging Data.

Objectives: The authors present a method that focuses on cohort matching algorithms for performing patient-to-patient comparisons along multiple echocardiographic parameters for predicting meaningful patient subgroups.

Background: Recent efforts in collecting multiomics data open numerous opportunities for comprehensive integration of highly heterogenous data to classify a patient's cardiovascular state, eventually leading to tailored therapies.

Methods: A total of 42 echocardiography features, including 2-dimensional and Doppler measurements, left ventricular (LV) and atrial speckle-tracking, and vector flow mapping data, were obtained in 297 patients.

A low-cost texture-based pipeline for predicting myocardial tissue remodeling and fibrosis using cardiac ultrasound.

Background: Maturation of ultrasound myocardial tissue characterization may have far-reaching implications as a widely available alternative to cardiac magnetic resonance (CMR) for risk stratification in left ventricular (LV) remodeling.

Methods: We extracted 328 texture-based features of myocardium from still ultrasound images. After we explored the phenotypes of myocardial textures using unsupervised similarity networks, global LV remodeling parameters were predicted using supervised machine learning models.

Interpatient Similarities in Cardiac Function: A Platform for Personalized Cardiovascular Medicine.

Objectives: The authors applied unsupervised machine-learning techniques for integrating echocardiographic features of left ventricular (LV) structure and function into a patient similarity network that predicted major adverse cardiac event(s) (MACE) in an individual patient.

Background: Patient similarity analysis is an evolving paradigm for precision medicine in which patients are clustered or classified based on their similarities in several clinical features.

Methods: A retrospective cohort of 866 patients was used to develop a network architecture using 9 echocardiographic features of LV structure and function.

Network Tomography for Understanding Phenotypic Presentations in Aortic Stenosis.

Objectives: This study sought to build a patient-patient similarity network using multiple features of left ventricular (LV) structure and function in patients with aortic stenosis (AS). The study further validated the observations in an experimental murine model of AS.

Background: The LV response in AS is variable and results in heterogeneous phenotypic presentations.

Pathophysiology of Aortic Valve Stenosis: Is It Both Fibrocalcific and Sex Specific?

Our understanding of the fundamental biology and identification of efficacious therapeutic targets in aortic valve stenosis has lagged far behind the fields of atherosclerosis and heart failure. In this review, we highlight the most clinically relevant problems facing men and women with fibrocalcific aortic valve stenosis, discuss the fundamental biology underlying valve calcification and fibrosis, and identify key molecular points of intersection with sex hormone signaling.

Echocardiographic Approaches and Protocols for Comprehensive Phenotypic Characterization of Valvular Heart Disease in Mice.

The aim of this manuscript and accompanying video is to provide an overview of the methods and approaches used for imaging heart valve function in rodents, with detailed descriptions of the appropriate methods for anesthesia, the echocardiographic windows used, the imaging planes and probe orientations for image acquisition, the methods for data analysis, and the limitations of emerging technologies for the evaluation of cardiac and valvular function. Importantly, we also highlight several future areas of research in cardiac and heart valve imaging that may be leveraged to gain insights into the pathogenesis of valve disease in preclinical animal models. We propose that using a systematic approach to evaluating cardiac and heart valve function in mice can result in more robust and reproducible data, as well as facilitate the discovery of previously underappreciated phenotypes in genetically-altered and/or physiologically-stressed mice.

Naturally occurring p16(Ink4a)-positive cells shorten healthy lifespan.

Cellular senescence, a stress-induced irreversible growth arrest often characterized by expression of p16(Ink4a) (encoded by the Ink4a/Arf locus, also known as Cdkn2a) and a distinctive secretory phenotype, prevents the proliferation of preneoplastic cells and has beneficial roles in tissue remodelling during embryogenesis and wound healing. Senescent cells accumulate in various tissues and organs over time, and have been speculated to have a role in ageing. To explore the physiological relevance and consequences of naturally occurring senescent cells, here we use a previously established transgene, INK-ATTAC, to induce apoptosis in p16(Ink4a)-expressing cells of wild-type mice by injection of AP20187 twice a week starting at one year of age.

17α-Estradiol Alleviates Age-related Metabolic and Inflammatory Dysfunction in Male Mice Without Inducing Feminization.

Aging is associated with visceral adiposity, metabolic disorders, and chronic low-grade inflammation. 17α-estradiol (17α-E2), a naturally occurring enantiomer of 17β-estradiol (17β-E2), extends life span in male mice through unresolved mechanisms. We tested whether 17α-E2 could alleviate age-related metabolic dysfunction and inflammation.

Nonbiased Molecular Screening Identifies Novel Molecular Regulators of Fibrogenic and Proliferative Signaling in Myxomatous Mitral Valve Disease.

Background: Pathological processes underlying myxomatous mitral valve degeneration (MMVD) remain poorly understood. We sought to identify novel mechanisms contributing to the development of this condition.

Methods And Results: Microarrays were used to measure gene expression in 11 myxomatous and 11 nonmyxomatous human mitral valves.

Infiltrative cardiovascular diseases: cardiomyopathies that look alike.

Infiltrative cardiomyopathies are characterized by the deposition of abnormal substances that cause the ventricular walls to become progressively rigid, thereby impeding ventricular filling. Some infiltrative cardiac diseases increase ventricular wall thickness, while others cause chamber enlargement with secondary wall thinning. Increased wall thickness, small ventricular volume, and occasional dynamic left ventricular outflow obstruction (e.

Does left atrial size predict mortality in asymptomatic patients with severe aortic stenosis?

Background: We assessed the hypothesis that diastolic function represented by left atrial size determines the rate of development of symptoms and the risk of all-cause mortality in asymptomatic patients with severe aortic stenosis (AS).

Methods: From a database of 622 asymptomatic patients with isolated severe AS (velocity by Doppler >or= 4 m/sec) followed for 5.4 +/- 4 years, we reviewed the echocardiograms and evaluated Doppler echocardiographic indices of diastolic function.

C-reactive protein, left atrial volume, and atrial fibrillation: a prospective study in high-risk elderly.

Background: The data regarding the interrelationships of high-sensitive C-reactive protein (CRP), left atrial (LA) volume, and atrial fibrillation (AF) are sparse. Additionally, while LA volume has been shown to be useful for prediction of AF in low-to-moderate risk populations, its predictive value in clinically high-risk populations is unknown.

Methods: SAFHIRE (Study of Atrial Fibrillation in High Risk Elderly) is an ongoing prospective study of the pathophysiology of first AF in persons aged > or = 65 years with > or = 2 other AF risk factors [systemic hypertension, proven coronary artery disease, heart failure (HF), diabetes].

Diastolic dysfunction and left atrial enlargement as contributing factors to functional mitral regurgitation in dilated cardiomyopathy: data from the Acorn trial.

Background: Functional mitral regurgitation (MR) is commonly seen in dilated cardiomyopathy (DCM), which may result from left ventricular (LV) dilatation and alteration in the geometric relationship of mitral valve apparatus. However, not all patients with DCM show significant MR and left atrial (LA) enlargement. The aim of this study was to assess responsible factors for developing mitral valve regurgitation.

Frequency and predictors of urgent coronary angiography in patients with acute pericarditis.

Objectives: To determine the frequency of urgent coronary angiography in patients with acute pericarditis and to examine clinical characteristics associated with coronary angiography.

Patients And Methods: This is a retrospective analysis of all incident cases of acute viral or idiopathic pericarditis evaluated at Mayo Clinic's site in Rochester, MN, between January 1, 2000, and December 31, 2006. The main outcome measures were use of urgent coronary angiography and rate of concomitant coronary artery disease in patients with pericarditis.

Left atrial reservoir function as a potent marker for first atrial fibrillation or flutter in persons > or = 65 years of age.

The aim of this prospective study was to evaluate the incremental value of left atrial (LA) function for the prediction of risk for first atrial fibrillation (AF) or atrial flutter. Maximum and minimum LA volumes were quantitated by echocardiography in 574 adults (mean age 74 +/- 6 years, 52% men) without a history or evidence of atrial arrhythmia. During a mean follow-up period of 1.

E/Ea is the major determinant of pulmonary artery pressure in moderate to severe aortic stenosis.

Objective: Our aim was to determine echocardiographic Doppler predictors of pulmonary artery systolic pressure (PASP) in patients with moderate to severe aortic stenosis (AS).

Methods: In this retrospective study of 50 patients with moderate to severe AS, the determinants of PASP were analyzed.

Results: Aortic valve area was 0.