Fully Automated Artificial Intelligence Assessment of Aortic Stenosis by Echocardiography.


Journal

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
ISSN: 1097-6795
Titre abrégé: J Am Soc Echocardiogr
Pays: United States
ID NLM: 8801388

Informations de publication

Date de publication:
Jul 2023
Historique:
received: 19 10 2022
revised: 07 03 2023
accepted: 10 03 2023
medline: 10 7 2023
pubmed: 24 3 2023
entrez: 23 3 2023
Statut: ppublish

Résumé

Aortic stenosis (AS) is a common form of valvular heart disease, present in over 12% of the population age 75 years and above. Transthoracic echocardiography (TTE) is the first line of imaging in the adjudication of AS severity but is time-consuming and requires expert sonographic and interpretation capabilities to yield accurate results. Artificial intelligence (AI) technology has emerged as a useful tool to address these limitations but has not yet been applied in a fully hands-off manner to evaluate AS. Here, we correlate artificial neural network measurements of key hemodynamic AS parameters to experienced human reader assessment. Two-dimensional and Doppler echocardiographic images from patients with normal aortic valves and all degrees of AS were analyzed by an artificial neural network (Us2.ai) with no human input to measure key variables in AS assessment. Trained echocardiographers blinded to AI data performed manual measurements of these variables, and correlation analyses were performed. Our cohort included 256 patients with an average age of 67.6 ± 9.5 years. Across all AS severities, AI closely matched human measurement of aortic valve peak velocity (r = 0.97, P < .001), mean pressure gradient (r = 0.94, P < .001), aortic valve area by continuity equation (r = 0.88, P < .001), stroke volume index (r = 0.79, P < .001), left ventricular outflow tract velocity-time integral (r = 0.89, P < .001), aortic valve velocity-time integral (r = 0.96, P < .001), and left ventricular outflow tract diameter (r = 0.76, P < .001). Artificial neural networks have the capacity to closely mimic human measurement of all relevant parameters in the adjudication of AS severity. Application of this AI technology may minimize interscan variability, improve interpretation and diagnosis of AS, and allow for precise and reproducible identification and management of patients with AS.

Sections du résumé

BACKGROUND BACKGROUND
Aortic stenosis (AS) is a common form of valvular heart disease, present in over 12% of the population age 75 years and above. Transthoracic echocardiography (TTE) is the first line of imaging in the adjudication of AS severity but is time-consuming and requires expert sonographic and interpretation capabilities to yield accurate results. Artificial intelligence (AI) technology has emerged as a useful tool to address these limitations but has not yet been applied in a fully hands-off manner to evaluate AS. Here, we correlate artificial neural network measurements of key hemodynamic AS parameters to experienced human reader assessment.
METHODS METHODS
Two-dimensional and Doppler echocardiographic images from patients with normal aortic valves and all degrees of AS were analyzed by an artificial neural network (Us2.ai) with no human input to measure key variables in AS assessment. Trained echocardiographers blinded to AI data performed manual measurements of these variables, and correlation analyses were performed.
RESULTS RESULTS
Our cohort included 256 patients with an average age of 67.6 ± 9.5 years. Across all AS severities, AI closely matched human measurement of aortic valve peak velocity (r = 0.97, P < .001), mean pressure gradient (r = 0.94, P < .001), aortic valve area by continuity equation (r = 0.88, P < .001), stroke volume index (r = 0.79, P < .001), left ventricular outflow tract velocity-time integral (r = 0.89, P < .001), aortic valve velocity-time integral (r = 0.96, P < .001), and left ventricular outflow tract diameter (r = 0.76, P < .001).
CONCLUSIONS CONCLUSIONS
Artificial neural networks have the capacity to closely mimic human measurement of all relevant parameters in the adjudication of AS severity. Application of this AI technology may minimize interscan variability, improve interpretation and diagnosis of AS, and allow for precise and reproducible identification and management of patients with AS.

Identifiants

pubmed: 36958708
pii: S0894-7317(23)00158-X
doi: 10.1016/j.echo.2023.03.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

769-777

Informations de copyright

Published by Elsevier Inc.

Auteurs

Hema Krishna (H)

Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown VA Medical Center, Chicago, Illinois.

Kevin Desai (K)

Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.

Brody Slostad (B)

Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois.

Siddharth Bhayani (S)

Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.

Joshua H Arnold (JH)

Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.

Wouter Ouwerkerk (W)

National Heart Centre Singapore, Singapore; Department of Dermatology, Amsterdam UMC, Amsterdam, Netherlands.

Yoran Hummel (Y)

Us2.ai, Singapore.

Carolyn S P Lam (CSP)

National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore.

Justin Ezekowitz (J)

Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.

Matthew Frost (M)

Us2.ai, Singapore.

Zhubo Jiang (Z)

Us2.ai, Singapore.

Cyril Equilbec (C)

Us2.ai, Singapore.

Aamir Twing (A)

Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois.

Patricia A Pellikka (PA)

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

Leon Frazin (L)

Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown VA Medical Center, Chicago, Illinois.

Mayank Kansal (M)

Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois; Jesse Brown VA Medical Center, Chicago, Illinois. Electronic address: mmkansal@uic.edu.

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Classifications MeSH