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Advances in Artificial Intelligence Applied to Heart Failure
Published in Kayvan Najarian, Delaram Kahrobaei, Enrique Domínguez, Reza Soroushmehr, Artificial Intelligence in Healthcare and Medicine, 2022
Jose M. García-Pinilla, Francisco Lopez Valverde
ML has also been applied to standard features in echocardiography reports for the detection and evaluation of heart failure, including heart failure with preserved ejection fraction (HFpEF). For example, Reddy et al. used ML techniques to identify clinical and echocardiographic variables that were the most predictive of having a diagnosis of HFpEF (Reddy et al., 2018). Echocardiographic variables under consideration included features such as the estimated pulmonary artery filling pressure and E/e′ ratio. Using six variables selected by their ML algorithm, they created a risk score that resulted in an AUC of 0.841 for the diagnosis of HFpEF. This was notably higher than the performance of the European Society of Cardiology's 2016 algorithm for HFpEF detection on the same set of patients (AUC of 0.672), whose algorithm relies on variables such as BNP and other echocardiographic or imaging features. Creating a risk score based on ML-selected features allows for easier incorporation into clinical use, as these scores often are based on easy-to-obtain features.
Hypertension and Correlation to Cerebrovascular Change: A Brief Overview
Published in Ayman El-Baz, Jasjit S. Suri, Cardiovascular Imaging and Image Analysis, 2018
Heba Kandil, Dawn Sosnin, Ali Mahmoud, Ahmed Shalaby, Ahmed Soliman, Adel Elmaghraby, Jasjit S. Suri, Guruprasad Giridharan, Ayman El-Baz
Gating (or triggering) is the use of an electrocardiograph signal (cardiac), peripheral pulse or level of inspiration (respiratory) to select a particular point in the cardiac or respiratory cycle, which reduces cardiorespiratory movement artifacts and improves resolution in image acquisition. In retrospective gating, the ECG, pulse, or respiratory levels are recorded during continuous imaging, and correlation is performed during post-processing. Two gating methods (e.g., respiratory and cardiac) can be used to further improve image quality. Gating can be used to evaluate cardiac and pulmonary structures, such as coronary artery calcification (atherosclerosis) [55], [56]. An example of a specific diagnostic application was the recently proposed non-gated CTA method for differentiating between pulmonary hypertension (affecting the arteries in the lungs) due to heart failure with preserved ejection fraction (volume of blood ejected by the heart) and idiopathic pulmonary arterial hypertension [57]. Fast spin echo (FSE) MRA uses cardiac gating to capture images during systole, when both arteries and veins have high signal values, and during diastole, when arterial signal strength falls. Images of the arteries are created by subtracting the systole images from those taken during diastole. Another example of the critical importance of gating in acquiring images that are extremely sensitive to motion is the application of pulse triggering with diffusion weighted MRI (DW-MRI) of the brain (Brownian motion of water molecules) [58].
Asbestos-related pleural disease
Published in Dorsett D. Smith, The Health Effects of Asbestos, 2015
Asbestos-related pleuritis may rarely involve the pericardium and cause asbestos-related pericarditis, pericardial effusion, and constrictive pericarditis, as can a malignant mesothelioma. In my clinical experience, mesothelioma involving the pericardium is the most common cause of pericardial disease in the asbestos-exposed population and must always be excluded prior to making a diagnosis of a benign asbestos-related pericardial effusion. (Davies D, Andrews MI, Jones JS. Asbestos induced pericardial effusion and constrictive pericarditis. Thorax 1991;46(6):429–32; Abejie BA, Chung EH, Nesto RW, Kales SN. Grand rounds: Asbestos-related pericarditis in a boiler operator. Environ Health Perspect 2008;116(1):86–9; Roggeri A, Tomasi C, Cavazza A, Serra L, Zucchi L. Haemorrhagic pericardial effusion in an asbestos worker. Med Lav 2003;94(4):391–4; Fernandes R, Nosib S, Thomson D, Baniak N. A rare cause of heart failure with preserved ejection fraction: Primary pericardial mesothelioma masquerading as pericardial constriction. BMJ Case Rep 2014; Belli E, Landolfo K. Primary pericardial mesothelioma: A rare cause of constrictive pericarditis. Asian Cardiovasc Thorac Ann 2015;23(5):599–600.)
Recent advances in multimodality imaging of the tricuspid valve
Published in Expert Review of Medical Devices, 2021
Sergio Caravita, Stefano Figliozzi, Diana-Ruxandra Florescu, Valentina Volpato, Giorgio Oliverio, Michele Tomaselli, Camilla Torlasco, Giuseppe Muscogiuri, Franco Cernigliaro, Gianfranco Parati, Luigi Badano, Denisa Muraru
Differently from the ventricular-functional TR (where leaflet tethering secondary to RV enlargement is deemed to be an important mechanism), in atrial-functional TR, it is the RA dilation that predisposes to leaflet malcoaptation by promoting TA enlargement [31]. Atrial fibrillation (AF) is probably one of the major determinants of RA and TA remodeling and dilation in the general population, leading to edge-to-edge malcoaptation in the absence of leaflet tethering (small tenting volume) [32,33]. Accordingly, atrial-functional TR can occur in the absence of overt pressure or volume overload of the RV. Nonetheless, AF is an important risk factor for heart failure with preserved ejection fraction [34] since the loss of atrial contraction quite invariably leads to increased atrial pressure and predisposes to occult volume overload.
Feasibility and effects of high-intensity interval training in older adults living with HIV
Published in Journal of Sports Sciences, 2021
Brandon C. Briggs, Alice S. Ryan, John D. Sorkin, Krisann K. Oursler
Adults with HIV have an increased risk of CVD and heart failure, especially heart failure with preserved ejection fraction (HFpEF) (Butler et al., 2018; So-Armah & Freiberg, 2014). In the general geriatric population, HFpEF is the most common form of heart failure that appears to be driven by diastolic dysfunction and manifests as exercise intolerance (Kitzman et al., 2002). With limited pharmacologic treatment options, exercise training is key but the ideal combination of modality and intensity is still being studied (Fleg et al., 2015). However, interval training can improve diastolic function and exercise tolerance (Alves et al., 2012; Guiraud et al., 2012). This question is a priority in HIV research given the increased risk of diastolic dysfunction HFpEF and its association with CRF (Oursler et al., 2019) and chronic inflammation (Butler et al., 2018). Our results support further research in HIIT as an efficient and effective means to deliver high-intensity AEX toward the goal of attenuating the accelerated ageing process in adults with HIV.
The role of exercise hemodynamics in assessing patients with chronic heart failure and left ventricular assist devices
Published in Expert Review of Medical Devices, 2019
Aaron Koshy, Thomas Green, Anet Toms, Sophie Cassidy, Stephan Schueler, Djordje Jakovljevic, Guy A MacGowan
A study by Rieth et al [4] highlights the usefulness of invasive hemodynamic assessment in characterizing patients with CO and right heart pressures. CHF patients underwent right heart catheterization with exercise using a bicycle ergometer in the supine position. All hemodynamic measures excluding mixed venous oxygen saturation increased significantly from rest to exercise. It was found that a change (∆) in CO of >1.15L/min during exercise was associated with a significantly higher 5-year transplant/ventricular assist device-free survival compared to those with a lower ∆CO. Invasive exercise hemodynamics can performed with a variety of exercise modalities. Commonly a bicycle ergometer for supine exercise is used while the catheterization is done from an internal jugular vein or a brachial vein. Alternatives include straight leg raising which is simpler to perform though not standardized, and lifting arm weights for femoral catheterization. This flexibility has enabled patients with heart failure and preserved ejection fraction or an LVAD to be assessed for diagnosis or explantation, respectively [1,23]. However, invasive assessment has several drawbacks such as need for specialist supervision during procedure in theater, cost and in rare circumstances direct patient harm via infection, bleeding, arrhythmias, and pulmonary events.