Background: Deep learning interpretation of echocardiographic images may facilitate automated assessment of cardiac structure and function.
Objectives: We developed a deep learning model to interpret echocardiograms and examined the association of deep learning-derived echocardiographic measures with incident outcomes.
Methods: We trained and validated a 3-dimensional convolutional neural network model for echocardiographic view classification and quantification of left atrial dimension, left ventricular wall thickness, chamber diameter, and ejection fraction. The training sample comprised 64,028 echocardiograms (n = 27,135) from a retrospective multi-institutional ambulatory cardiology electronic health record sample. Validation was performed in a separate longitudinal primary care sample and an external health care system data set. Cox models evaluated the association of model-derived left heart measures with incident outcomes.
Results: Deep learning discriminated echocardiographic views (area under the receiver operating curve >0.97 for parasternal long axis, apical 4-chamber, and apical 2-chamber views vs human expert annotation) and quantified standard left heart measures (R range = 0.53 to 0.91 vs study report values). Model performance was similar in 2 external validation samples. Model-derived left heart measures predicted incident heart failure, atrial fibrillation, myocardial infarction, and death. A 1-SD lower model-left ventricular ejection fraction was associated with 43% greater risk of heart failure (HR: 1.43; 95% CI: 1.23-1.66) and 17% greater risk of death (HR: 1.17; 95% CI: 1.06-1.30). Similar results were observed for other model-derived left heart measures.
Conclusions: Deep learning echocardiographic interpretation accurately quantified standard measures of left heart structure and function, which in turn were associated with future clinical outcomes. Deep learning may enable automated echocardiogram interpretation and disease prediction at scale.
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http://dx.doi.org/10.1016/j.jacc.2023.09.800 | DOI Listing |
Med Image Anal
December 2024
Division of Pediatric Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA. Electronic address:
Patients with congenitally corrected transposition of the great arteries (ccTGA) can be treated with a double switch operation (DSO) to restore the normal anatomical connection of the left ventricle (LV) to the systemic circulation and the right ventricle (RV) to the pulmonary circulation. The subpulmonary LV progressively deconditions over time due to its connection to the low pressure pulmonary circulation and needs to be retrained using a surgical pulmonary artery band (PAB) for 6-12 months prior to the DSO. The subsequent clinical follow-up, consisting of invasive cardiac pressure and non-invasive imaging data, evaluates LV preparedness for the DSO.
View Article and Find Full Text PDFAm J Cardiol
December 2024
Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA. Electronic address:
The outcomes of bifurcation percutaneous coronary intervention (PCI) in octogenarians and nonagenarians have received limited study. We compared the procedural characteristics and outcomes of bifurcation PCIs among patients ≥80 vs <80-years-old in a multicenter registry. Of 1,253 patients who underwent 1,262 bifurcation PCIs between 2014 and 2024 at six centers, 194 (15%) were octogenarians or nonagenarians.
View Article and Find Full Text PDFJ Heart Lung Transplant
December 2024
Oregon Health Science University, Knight Cardiovascular Institute. Electronic address:
Pulmonary hypertension puts strain on the right ventricle (RV), leading to the widespread practice of oversizing donor hearts to mitigate complications. However, contemporary evidence for this practice is neutral. We studied the relationship between donor-recipient predicted heart mass (D/R PHM) ratios and increases in donor left ventricle (LV) and right ventricle (RV) mass.
View Article and Find Full Text PDFRev Esp Cardiol (Engl Ed)
December 2024
Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Diseases Unit, Department of Medicine, Huddinge, Karolinska Institute, Stockholm, Sweden.
Ann Vasc Surg
December 2024
MemorialCare Heart and Vascular Institute, 2801 Atlantic Ave., Long Beach, CA 90806.
Aortic dissection is the most common thoracic aortic emergency and is associated with significant morbidity and mortality. Initial complications are dependent on reduction of sheer stress against the aortic wall to protect against rupture and minimize progression of the aortic wall injury. In patients with dissection starting at or distal to the left subclavian artery (Stanford type B), initial management includes strict blood pressure and heart rate control with monitoring for any complications such as malperfusion, rupture or hemodynamic instability.
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