Development of artificial intelligence tools for invasive Doppler-based coronary microvascular assessment.

Coronary flow reserve (CFR) assessment has proven clinical utility, but Doppler-based methods are sensitive to noise and operator bias, limiting their clinical applicability. The objective of the study is to expand the adoption of invasive Doppler CFR, through the development of artificial intelligence (AI) algorithms to automatically quantify coronary Doppler quality and track flow velocity. A neural network was trained on images extracted from coronary Doppler flow recordings to score signal quality and derive values for coronary flow velocity and CFR. The outputs were independently validated against expert consensus. Artificial intelligence successfully quantified Doppler signal quality, with high agreement with expert consensus (Spearman's rho: 0.94), and within individual experts. Artificial intelligence automatically tracked flow velocity with superior numerical agreement against experts, when compared with the current console algorithm [AI flow vs. expert flow bias -1.68 cm/s, 95% confidence interval (CI) -2.13 to -1.23 cm/s, An AI-based system, trained by experts and independently validated, could assign a quality score to Doppler traces and derive coronary flow velocity and CFR. By making Doppler CFR more automated, precise, and operator-independent, AI could expand the clinical applicability of coronary microvascular assessment.

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.

Déclaration de conflit d'intérêts

Conflict of interest: C.M.C. has received grants or research support from Edwards Lifesciences, honoraria or consultation fees from Boston Scientific, Philips, Viz.ai, and Medtronic and is a shareholder of Cerebria.ai and Viz.ai. S.N. has received honoraria for speaking on Coronary Physiology from Phillips. H.S. has received educational funding from Amgen. R.A.-L. has received speaking fees from Philips Volcano. R.P. has acted as consultant to Philips. T.P.v.d.H. has served as a speaker at educational events organized by Philips Volcano, St Jude Medical (now Abbott), and Boston Scientific. S.S. reports speaking fees for Philips, Pfizer, and Astra Zenenca and an Educational Grant from Medtronic. N.V.R. reports grants from Philips, Abbott, and Biotronik, and personal fees from Medtronic. All other authors have no conflicts to disclose.