Pub Date : 2023-03-28eCollection Date: 2023-05-01DOI: 10.1093/ehjdh/ztad023
Joseph Keunhong Yi, Tyler Hyungtaek Rim, Sungha Park, Sung Soo Kim, Hyeon Chang Kim, Chan Joo Lee, Hyeonmin Kim, Geunyoung Lee, James Soo Ghim Lim, Yong Yu Tan, Marco Yu, Yih-Chung Tham, Ameet Bakhai, Eduard Shantsila, Paul Leeson, Gregory Y H Lip, Calvin W L Chin, Ching-Yu Cheng
Aims: This study aims to evaluate the ability of a deep-learning-based cardiovascular disease (CVD) retinal biomarker, Reti-CVD, to identify individuals with intermediate- and high-risk for CVD.
Methods and results: We defined the intermediate- and high-risk groups according to Pooled Cohort Equation (PCE), QRISK3, and modified Framingham Risk Score (FRS). Reti-CVD's prediction was compared to the number of individuals identified as intermediate- and high-risk according to standard CVD risk assessment tools, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the results. In the UK Biobank, among 48 260 participants, 20 643 (42.8%) and 7192 (14.9%) were classified into the intermediate- and high-risk groups according to PCE, and QRISK3, respectively. In the Singapore Epidemiology of Eye Diseases study, among 6810 participants, 3799 (55.8%) were classified as intermediate- and high-risk group according to modified FRS. Reti-CVD identified PCE-based intermediate- and high-risk groups with a sensitivity, specificity, PPV, and NPV of 82.7%, 87.6%, 86.5%, and 84.0%, respectively. Reti-CVD identified QRISK3-based intermediate- and high-risk groups with a sensitivity, specificity, PPV, and NPV of 82.6%, 85.5%, 49.9%, and 96.6%, respectively. Reti-CVD identified intermediate- and high-risk groups according to the modified FRS with a sensitivity, specificity, PPV, and NPV of 82.1%, 80.6%, 76.4%, and 85.5%, respectively.
Conclusion: The retinal photograph biomarker (Reti-CVD) was able to identify individuals with intermediate and high-risk for CVD, in accordance with existing risk assessment tools.
{"title":"Cardiovascular disease risk assessment using a deep-learning-based retinal biomarker: a comparison with existing risk scores.","authors":"Joseph Keunhong Yi, Tyler Hyungtaek Rim, Sungha Park, Sung Soo Kim, Hyeon Chang Kim, Chan Joo Lee, Hyeonmin Kim, Geunyoung Lee, James Soo Ghim Lim, Yong Yu Tan, Marco Yu, Yih-Chung Tham, Ameet Bakhai, Eduard Shantsila, Paul Leeson, Gregory Y H Lip, Calvin W L Chin, Ching-Yu Cheng","doi":"10.1093/ehjdh/ztad023","DOIUrl":"10.1093/ehjdh/ztad023","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to evaluate the ability of a deep-learning-based cardiovascular disease (CVD) retinal biomarker, Reti-CVD, to identify individuals with intermediate- and high-risk for CVD.</p><p><strong>Methods and results: </strong>We defined the intermediate- and high-risk groups according to Pooled Cohort Equation (PCE), QRISK3, and modified Framingham Risk Score (FRS). Reti-CVD's prediction was compared to the number of individuals identified as intermediate- and high-risk according to standard CVD risk assessment tools, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the results. In the UK Biobank, among 48 260 participants, 20 643 (42.8%) and 7192 (14.9%) were classified into the intermediate- and high-risk groups according to PCE, and QRISK3, respectively. In the Singapore Epidemiology of Eye Diseases study, among 6810 participants, 3799 (55.8%) were classified as intermediate- and high-risk group according to modified FRS. Reti-CVD identified PCE-based intermediate- and high-risk groups with a sensitivity, specificity, PPV, and NPV of 82.7%, 87.6%, 86.5%, and 84.0%, respectively. Reti-CVD identified QRISK3-based intermediate- and high-risk groups with a sensitivity, specificity, PPV, and NPV of 82.6%, 85.5%, 49.9%, and 96.6%, respectively. Reti-CVD identified intermediate- and high-risk groups according to the modified FRS with a sensitivity, specificity, PPV, and NPV of 82.1%, 80.6%, 76.4%, and 85.5%, respectively.</p><p><strong>Conclusion: </strong>The retinal photograph biomarker (Reti-CVD) was able to identify individuals with intermediate and high-risk for CVD, in accordance with existing risk assessment tools.</p>","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/11/ztad023.PMC10232236.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9571920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-23eCollection Date: 2023-05-01DOI: 10.1093/ehjdh/ztad022
Fabian Theurl, Michael Schreinlechner, Nikolay Sappler, Michael Toifl, Theresa Dolejsi, Florian Hofer, Celine Massmann, Christian Steinbring, Silvia Komarek, Kurt Mölgg, Benjamin Dejakum, Christian Böhme, Rudolf Kirchmair, Sebastian Reinstadler, Axel Bauer
Aims: We aimed to investigate the concordance between heart rate variability (HRV) derived from the photoplethysmographic (PPG) signal of a commercially available smartwatch compared with the gold-standard high-resolution electrocardiogram (ECG)-derived HRV in patients with cardiovascular disease.
Methods and results: We prospectively enrolled 104 survivors of acute ST-elevation myocardial infarction, 129 patients after an ischaemic stroke, and 30 controls. All subjects underwent simultaneous recording of a smartwatch (Garmin vivoactive 4; Garmin Ltd, Olathe, KS, USA)-derived PPG signal and a high-resolution (1000 Hz) ECG for 30 min under standardized conditions. HRV measures in time and frequency domain, non-linear measures, as well as deceleration capacity (DC) were calculated according to previously published technologies from both signals. Lin's concordance correlation coefficient (ρc) between smartwatch-derived and ECG-based HRV markers was used as a measure of diagnostic accuracy. A very high concordance within the whole study cohort was observed for the mean heart rate (ρc = 0.9998), standard deviation of the averages of normal-to-normal (NN) intervals in all 5min segments (SDANN; ρc = 0.9617), and very low frequency power (VLF power; ρc = 0.9613). In contrast, detrended fluctuation analysis (DF-α1; ρc = 0.5919) and the square mean root of the sum of squares of adjacent NN-interval differences (rMSSD; ρc = 0.6617) showed only moderate concordance.
Conclusion: Smartwatch-derived HRV provides a practical alternative with excellent accuracy compared with ECG-based HRV for global markers and those characterizing lower frequency components. However, caution is warranted with HRV markers that predominantly assess short-term variability.
{"title":"Smartwatch-derived heart rate variability: a head-to-head comparison with the gold standard in cardiovascular disease.","authors":"Fabian Theurl, Michael Schreinlechner, Nikolay Sappler, Michael Toifl, Theresa Dolejsi, Florian Hofer, Celine Massmann, Christian Steinbring, Silvia Komarek, Kurt Mölgg, Benjamin Dejakum, Christian Böhme, Rudolf Kirchmair, Sebastian Reinstadler, Axel Bauer","doi":"10.1093/ehjdh/ztad022","DOIUrl":"10.1093/ehjdh/ztad022","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to investigate the concordance between heart rate variability (HRV) derived from the photoplethysmographic (PPG) signal of a commercially available smartwatch compared with the gold-standard high-resolution electrocardiogram (ECG)-derived HRV in patients with cardiovascular disease.</p><p><strong>Methods and results: </strong>We prospectively enrolled 104 survivors of acute ST-elevation myocardial infarction, 129 patients after an ischaemic stroke, and 30 controls. All subjects underwent simultaneous recording of a smartwatch (Garmin vivoactive 4; Garmin Ltd, Olathe, KS, USA)-derived PPG signal and a high-resolution (1000 Hz) ECG for 30 min under standardized conditions. HRV measures in time and frequency domain, non-linear measures, as well as deceleration capacity (DC) were calculated according to previously published technologies from both signals. Lin's concordance correlation coefficient (<i>ρ</i><sub>c</sub>) between smartwatch-derived and ECG-based HRV markers was used as a measure of diagnostic accuracy. A very high concordance within the whole study cohort was observed for the mean heart rate (<i>ρ</i><sub>c</sub> = 0.9998), standard deviation of the averages of normal-to-normal (NN) intervals in all 5min segments (SDANN; <i>ρ</i><sub>c</sub> = 0.9617), and very low frequency power (VLF power; <i>ρ</i><sub>c</sub> = 0.9613). In contrast, detrended fluctuation analysis (DF-α1; <i>ρ</i><sub>c</sub> = 0.5919) and the square mean root of the sum of squares of adjacent NN-interval differences (rMSSD; <i>ρ</i><sub>c</sub> = 0.6617) showed only moderate concordance.</p><p><strong>Conclusion: </strong>Smartwatch-derived HRV provides a practical alternative with excellent accuracy compared with ECG-based HRV for global markers and those characterizing lower frequency components. However, caution is warranted with HRV markers that predominantly assess short-term variability.</p>","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/d9/ztad022.PMC10232241.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
[This corrects the article DOI: 10.1093/ehjdh/ztac026.].
[这更正了文章DOI: 10.1093/ehjdh/ztac026.]。
{"title":"Corrigendum to: ESC Working Group on e-Cardiology Position Paper: accuracy and reliability of electrocardiogram monitoring in the detection of atrial fibrillation in cryptogenic stroke patients : In collaboration with the Council on Stroke, the European Heart Rhythm Association, and the Digital Health Committee.","authors":"","doi":"10.1093/ehjdh/ztad019","DOIUrl":"https://doi.org/10.1093/ehjdh/ztad019","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjdh/ztac026.].</p>","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/71/ztad019.PMC10039420.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9547118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter de Jaegere, Robert van der Boon, Joost Lumens, Nico Bruining
{"title":"PubMed indexation for the European Heart Journal - Digital Health: a small step for the European Heart Journal family, a giant leap in the digital future of cardiovascular disease management.","authors":"Peter de Jaegere, Robert van der Boon, Joost Lumens, Nico Bruining","doi":"10.1093/ehjdh/ztad013","DOIUrl":"https://doi.org/10.1093/ehjdh/ztad013","url":null,"abstract":"","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9567929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We read with great interest the manuscript by Whitelaw et al. assessing the barriers and facilitators of the uptake of digital health technology (DHT) in cardiovascular care: a systematic review. 1 They conclude that there are a multitude of barriers and facilitators to the uptake of DHT in cardiovascular care; internet access, user-friendliness, organiza-tional support, workflow efficiency
{"title":"Clinician-to-clinician electronic consultation in cardiology is also a digital health technology for cardiovascular care.","authors":"José R González-Juanatey, Sergio Cinza Sanjurjo","doi":"10.1093/ehjdh/ztad011","DOIUrl":"https://doi.org/10.1093/ehjdh/ztad011","url":null,"abstract":"We read with great interest the manuscript by Whitelaw et al. assessing the barriers and facilitators of the uptake of digital health technology (DHT) in cardiovascular care: a systematic review. 1 They conclude that there are a multitude of barriers and facilitators to the uptake of DHT in cardiovascular care; internet access, user-friendliness, organiza-tional support, workflow efficiency","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/31/ztad011.PMC10039421.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9567932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pilar Mazón-Ramos, Sergio Cinza-Sanjurjo, David Garcia-Vega, Manuel Portela-Romero, Juan C Sanmartin-Pena, Daniel Rey-Aldana, Amparo Martinez-Monzonis, Jenifer Espasandín-Domínguez, Francisco Gude-Sampedro, José R González-Juanatey
Aims: We aimed to assess longer-term results (accessibility, hospital admissions, and mortality) in elderly patients referred to a cardiology department (CD) from primary care using e-consultation in outpatient care.
Methods and results: We included 9963 patients >80 years from 1 January 2010 to 31 December 2019. Until 2012, all patients attended an in-person consultation (2010-2012). In 2013, we instituted an e-consult programme (2013-2019) for all primary care referrals to cardiologists that preceded a patient's in-person consultation when considered. We used an interrupted time series (ITS) regression approach to investigate the impact of e-consultation on (i) cardiovascular hospital admissions and mortality. We also analysed (ii) the total number and referral rate (population-adjusted referred rate) in both periods, and (iii) the accessibility was measured as the number of consultations and variation according to the distance from the municipality and reference hospital. During e-consultation, the demand for care increased (12.8 ± 4.3% vs. 25.5 ± 11.1% per 1000 inhabitants, P < 0.001) and referrals from different areas were equalized. After the implementation of e-consultation, we observed that the increase in hospital admissions and mortality were stabilized [incidence rate ratio (iRR): 1.351 (95% CI, 0.787, 2.317), P = 0.874] and [iRR: 1.925 (95% CI: 0.889, 4.168), P = 0.096], respectively. The geographic variabilities in hospital admissions and mortality seen during the in-person consultation were stabilized after e-consultation implementation.
Conclusions: Implementation of a clinician-to-clinician e-consultation programme in outpatient care was associated with improved accessibility to cardiology healthcare in elderly patients. After e-consultations were implemented, hospital admissions and mortality were stabilized.
目的:我们的目的是评估从初级保健转到心脏病科(CD)的老年患者在门诊护理中使用电子咨询的长期结果(可及性、住院率和死亡率)。方法和结果:从2010年1月1日至2019年12月31日,我们纳入了9963例>80岁的患者。直到2012年,所有患者都参加了面对面的咨询(2010-2012)。2013年,我们制定了一项电子咨询计划(2013-2019年),用于在患者进行面对面咨询之前向心脏病专家转诊的所有初级保健。我们使用中断时间序列(ITS)回归方法来调查电子会诊对心血管住院率和死亡率的影响。我们还分析了(ii)两个时期的总人数和转诊率(人口调整转诊率),以及(iii)可及性以咨询次数和根据与市政当局和参考医院的距离的变化来衡量。在电子咨询期间,护理需求增加(12.8±4.3% vs. 25.5±11.1% / 1000居民,P < 0.001),来自不同地区的转诊是均等的。实施电子会诊后,我们观察到住院率和死亡率的增加趋于稳定[发病率比(iRR): 1.351 (95% CI: 0.787, 2.317), P = 0.874]和[iRR: 1.925 (95% CI: 0.889, 4.168), P = 0.096]。实施电子会诊后,住院率和死亡率的地理差异趋于稳定。结论:在门诊实施临床医生对临床医生的电子咨询方案与老年患者心脏病保健的可及性改善有关。实施电子会诊后,住院率和死亡率稳定下来。
{"title":"A clinician-to-clinician universal electronic consultation programme at the cardiology department of a Galician healthcare area improves healthcare accessibility and outcomes in elderly patients.","authors":"Pilar Mazón-Ramos, Sergio Cinza-Sanjurjo, David Garcia-Vega, Manuel Portela-Romero, Juan C Sanmartin-Pena, Daniel Rey-Aldana, Amparo Martinez-Monzonis, Jenifer Espasandín-Domínguez, Francisco Gude-Sampedro, José R González-Juanatey","doi":"10.1093/ehjdh/ztad004","DOIUrl":"https://doi.org/10.1093/ehjdh/ztad004","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to assess longer-term results (accessibility, hospital admissions, and mortality) in elderly patients referred to a cardiology department (CD) from primary care using e-consultation in outpatient care.</p><p><strong>Methods and results: </strong>We included 9963 patients >80 years from 1 January 2010 to 31 December 2019. Until 2012, all patients attended an in-person consultation (2010-2012). In 2013, we instituted an e-consult programme (2013-2019) for all primary care referrals to cardiologists that preceded a patient's in-person consultation when considered. We used an interrupted time series (ITS) regression approach to investigate the impact of e-consultation on (i) cardiovascular hospital admissions and mortality. We also analysed (ii) the total number and referral rate (population-adjusted referred rate) in both periods, and (iii) the accessibility was measured as the number of consultations and variation according to the distance from the municipality and reference hospital. During e-consultation, the demand for care increased (12.8 ± 4.3% vs. 25.5 ± 11.1% per 1000 inhabitants, <i>P</i> < 0.001) and referrals from different areas were equalized. After the implementation of e-consultation, we observed that the increase in hospital admissions and mortality were stabilized [incidence rate ratio (iRR): 1.351 (95% CI, 0.787, 2.317), <i>P</i> = 0.874] and [iRR: 1.925 (95% CI: 0.889, 4.168), <i>P</i> = 0.096], respectively. The geographic variabilities in hospital admissions and mortality seen during the in-person consultation were stabilized after e-consultation implementation.</p><p><strong>Conclusions: </strong>Implementation of a clinician-to-clinician e-consultation programme in outpatient care was associated with improved accessibility to cardiology healthcare in elderly patients. After e-consultations were implemented, hospital admissions and mortality were stabilized.</p>","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/1a/ztad004.PMC10039426.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9567934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samantha K Engrav, Jeffrey B Geske, Konstantinos C Siontis
,
{"title":"Determining the cause of cardiac arrest: artificial intelligence at the bedside.","authors":"Samantha K Engrav, Jeffrey B Geske, Konstantinos C Siontis","doi":"10.1093/ehjdh/ztad002","DOIUrl":"https://doi.org/10.1093/ehjdh/ztad002","url":null,"abstract":",","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/ee/ztad002.PMC10039424.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9567930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel J Taylor, Jeroen Feher, Krzysztof Czechowicz, Ian Halliday, D R Hose, Rebecca Gosling, Louise Aubiniere-Robb, Marcel Van't Veer, Danielle C J Keulards, Pim Tonino, Michel Rochette, Julian P Gunn, Paul D Morris
Aims: Ischaemic heart disease results from insufficient coronary blood flow. Direct measurement of absolute flow (mL/min) is feasible, but has not entered routine clinical practice in most catheterization laboratories. Interventional cardiologists, therefore, rely on surrogate markers of flow. Recently, we described a computational fluid dynamics (CFD) method for predicting flow that differentiates inlet, side branch, and outlet flows during angiography. In the current study, we evaluate a new method that regionalizes flow along the length of the artery.
Methods and results: Three-dimensional coronary anatomy was reconstructed from angiograms from 20 patients with chronic coronary syndrome. All flows were computed using CFD by applying the pressure gradient to the reconstructed geometry. Side branch flow was modelled as a porous wall boundary. Side branch flow magnitude was based on morphometric scaling laws with two models: a homogeneous model with flow loss along the entire arterial length; and a regionalized model with flow proportional to local taper. Flow results were validated against invasive measurements of flow by continuous infusion thermodilution (Coroventis™, Abbott). Both methods quantified flow relative to the invasive measures: homogeneous (r 0.47, P 0.006; zero bias; 95% CI -168 to +168 mL/min); regionalized method (r 0.43, P 0.013; zero bias; 95% CI -175 to +175 mL/min).
Conclusion: During angiography and pressure wire assessment, coronary flow can now be regionalized and differentiated at the inlet, outlet, and side branches. The effect of epicardial disease on agreement suggests the model may be best targeted at cases with a stenosis close to side branches.
目的:缺血性心脏病是由冠状动脉血流不足引起的。直接测量绝对流量(mL/min)是可行的,但在大多数导管实验室尚未进入常规临床实践。因此,介入心脏病专家依赖于血流的替代标记物。最近,我们描述了一种计算流体动力学(CFD)方法,用于在血管造影期间区分入口、侧分支和出口流动。在目前的研究中,我们评估了一种新的方法,沿着动脉的长度来划分血流。方法与结果:对20例慢性冠状动脉综合征患者的血管造影资料进行冠状动脉三维解剖重建。通过将压力梯度应用于重建的几何形状,使用CFD计算所有流动。侧枝流动模拟为多孔壁面边界。侧支流量大小基于形态学标度规律,有两种模型:沿整个动脉长度的流量损失均匀模型;建立了流量与局部锥度成正比的区域化模型。通过连续输注热稀释(Coroventis™,雅培)进行有创性流量测量,验证流量结果。两种方法都量化了相对于侵入性措施的流量:均质性(r 0.47, P 0.006;零偏差;95% CI -168 ~ +168 mL/min);区域化方法(r 0.43, P 0.013;零偏差;95% CI -175 ~ +175 mL/min)。结论:在血管造影和压力线评估中,冠状动脉血流可以在入口、出口和侧支进行分区和区分。心外膜疾病对一致性的影响表明该模型可能最适合侧支狭窄的病例。
{"title":"Validation of a novel numerical model to predict regionalized blood flow in the coronary arteries.","authors":"Daniel J Taylor, Jeroen Feher, Krzysztof Czechowicz, Ian Halliday, D R Hose, Rebecca Gosling, Louise Aubiniere-Robb, Marcel Van't Veer, Danielle C J Keulards, Pim Tonino, Michel Rochette, Julian P Gunn, Paul D Morris","doi":"10.1093/ehjdh/ztac077","DOIUrl":"https://doi.org/10.1093/ehjdh/ztac077","url":null,"abstract":"<p><strong>Aims: </strong>Ischaemic heart disease results from insufficient coronary blood flow. Direct measurement of absolute flow (mL/min) is feasible, but has not entered routine clinical practice in most catheterization laboratories. Interventional cardiologists, therefore, rely on surrogate markers of flow. Recently, we described a computational fluid dynamics (CFD) method for predicting flow that differentiates inlet, side branch, and outlet flows during angiography. In the current study, we evaluate a new method that regionalizes flow along the length of the artery.</p><p><strong>Methods and results: </strong>Three-dimensional coronary anatomy was reconstructed from angiograms from 20 patients with chronic coronary syndrome. All flows were computed using CFD by applying the pressure gradient to the reconstructed geometry. Side branch flow was modelled as a porous wall boundary. Side branch flow magnitude was based on morphometric scaling laws with two models: a homogeneous model with flow loss along the entire arterial length; and a regionalized model with flow proportional to local taper. Flow results were validated against invasive measurements of flow by continuous infusion thermodilution (Coroventis™, Abbott). Both methods quantified flow relative to the invasive measures: homogeneous (<i>r</i> 0.47, <i>P</i> 0.006; zero bias; 95% CI -168 to +168 mL/min); regionalized method (<i>r</i> 0.43, <i>P</i> 0.013; zero bias; 95% CI -175 to +175 mL/min).</p><p><strong>Conclusion: </strong>During angiography and pressure wire assessment, coronary flow can now be regionalized and differentiated at the inlet, outlet, and side branches. The effect of epicardial disease on agreement suggests the model may be best targeted at cases with a stenosis close to side branches.</p>","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9552636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Currently, virtual reality (VR) constitutes a vital aspect of digital health, necessitating an overview of study trends. We classified type A studies as those in which health care providers utilized VR devices and type B studies as those in which patients employed the devices. This study aimed to analyse the characteristics of each type of studies using natural language processing (NLP) methods.
Methods and results: Literature related to VR in cardiovascular research was searched in PubMed between 2010 and 2022. The characteristics of studies were analysed based on their classification as type A or type B. Abstracts of the studies were used as corpus for text mining. A binary logistic regression model was trained to automatically categorize the abstracts into the two study types. Classification performance was evaluated by accuracy, precision, recall, F-1 score, and c-statistics of the receiver operator curve (ROC) analysis. In total, 171 articles met the inclusion criteria, where 120 (70.2%) were type A studies and 51 (29.8%) were type B studies. Type A studies had a higher proportion of case reports than type B studies (18.3% vs. 3.9%, P = 0.01). As for abstract classification, the binary logistic regression model yielded 88% accuracy and an area under the ROC of 0.98. The words 'training', '3d', and 'simulation' were the most powerful determinants of type A studies, while the words 'patients', 'anxiety', and 'rehabilitation' were more indicative for type B studies.
Conclusions: NLP methods revealed the characteristics of the two types of VR-related research in cardiology.
{"title":"Automated categorization of virtual reality studies in cardiology based on the device usage: a bibliometric analysis (2010-2022).","authors":"Akinori Higaki, Yuta Watanabe, Yusuke Akazawa, Toru Miyoshi, Hiroshi Kawakami, Fumiyasu Seike, Haruhiko Higashi, Takayuki Nagai, Kazuhisa Nishimura, Katsuji Inoue, Shuntaro Ikeda, Osamu Yamaguchi","doi":"10.1093/ehjdh/ztad008","DOIUrl":"https://doi.org/10.1093/ehjdh/ztad008","url":null,"abstract":"<p><strong>Aims: </strong>Currently, virtual reality (VR) constitutes a vital aspect of digital health, necessitating an overview of study trends. We classified type A studies as those in which health care providers utilized VR devices and type B studies as those in which patients employed the devices. This study aimed to analyse the characteristics of each type of studies using natural language processing (NLP) methods.</p><p><strong>Methods and results: </strong>Literature related to VR in cardiovascular research was searched in PubMed between 2010 and 2022. The characteristics of studies were analysed based on their classification as type A or type B. Abstracts of the studies were used as corpus for text mining. A binary logistic regression model was trained to automatically categorize the abstracts into the two study types. Classification performance was evaluated by accuracy, precision, recall, F-1 score, and c-statistics of the receiver operator curve (ROC) analysis. In total, 171 articles met the inclusion criteria, where 120 (70.2%) were type A studies and 51 (29.8%) were type B studies. Type A studies had a higher proportion of case reports than type B studies (18.3% vs. 3.9%, <i>P</i> = 0.01). As for abstract classification, the binary logistic regression model yielded 88% accuracy and an area under the ROC of 0.98. The words 'training', '3d', and 'simulation' were the most powerful determinants of type A studies, while the words 'patients', 'anxiety', and 'rehabilitation' were more indicative for type B studies.</p><p><strong>Conclusions: </strong>NLP methods revealed the characteristics of the two types of VR-related research in cardiology.</p>","PeriodicalId":72965,"journal":{"name":"European heart journal. Digital health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/62/ztad008.PMC10039423.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9198159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}