Corrigendum to “The effect of cardiac rhythm on artificial intelligence-enabled ECG evaluation of left ventricular ejection fraction prediction in cardiac intensive care unit patients” Int J Cardiol. 2021 Sep 15;339:54-55

Left ventricular ejection fraction (LVEF) constitutes an important physiological parameter for the assessment of cardiac function, particularly in the settings of coronary artery disease and heart failure. This study explores the use of routinely and easily acquired variables in the intensive care unit (ICU) to predict severely depressed LVEF following ICU admission. A retrospective study was conducted. We extracted clinical physiological variables derived from ICU monitoring and available within the MIMIC II database and developed a fuzzy model using sequential feature selection and compared it with the conventional logistic regression (LR) model. Maximum predictive performance was observed using easily acquired ICU variables within 6 hours after admission and satisfactory predictive performance was achieved using variables acquired as early as one hour after admission. The fuzzy model is able to predict LVEF ≤ 25% with an AUC of 0.71 ± 0.07, outperforming the LR model, with an AUC of 0.67 ± 0.07. To the best of the authors’ knowledge, this is the first study predicting severely impaired LVEF using multivariate analysis of routinely collected data in the ICU. We recommend inclusion of these findings into triaged management plans that balance urgency with resources and clinical status, particularly for reducing the time of echocardiographic examination.

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Artificial Intelligence-Powered Measurement of Left Ventricular Ejection Fraction Using a Handheld Ultrasound Device

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2020.12.003 ◽

2021 ◽

Vol 47 (4) ◽

pp. 1120-1125

Author(s):

Dominika Filipiak-Strzecka ◽

Jarosław D. Kasprzak ◽

Paulina Wejner-Mik ◽

Ewa Szymczyk ◽

Katarzyna Wdowiak-Okrojek ◽

...

Keyword(s):

Artificial Intelligence ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Ventricular Ejection ◽

Left Ventricular Ejection ◽

Ventricular Ejection Fraction ◽

Ultrasound Device ◽

Handheld Ultrasound

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Validation of an Artificial Intelligence Left Ventricular Ejection Fraction Quantification Software with Cardiac Magnetic Resonance Imaging in Consecutive Non-Selected Patients

10.26226/morressier.5ebc4ac6ffea6f735881a42a ◽

2020 ◽

Author(s):

Ashton Lai

Keyword(s):

Magnetic Resonance Imaging ◽

Artificial Intelligence ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Left Ventricular Ejection Fraction ◽

Ejection Fraction ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Resonance Imaging ◽

Ventricular Ejection Fraction

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Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units

European Heart Journal ◽

10.1093/ehjci/ehaa946.1838 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Ishii ◽

H Takahashi ◽

H Nishimura ◽

W Fujiwara ◽

M Ohta ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Soluble Cd14 ◽

Baseline Model ◽

Ventricular Ejection Fraction ◽

Coronary Syndrome ◽

Increased Risk ◽

Cardiac Intensive Care

Abstract Background Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known. Objective We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality. Methods We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death. Results During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P<0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P<0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P<0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P<0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (46% vs. 52%, P<0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P<0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P<0.0001). Quartiles of presepsin levels were significantly (P<0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone. Conclusions Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs. Presepsin quartiles and mortality Funding Acknowledgement Type of funding source: None

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Point-of-care ultrasound for COVID-19 pneumonia patients in the ICU

10.21203/rs.3.rs-49196/v1 ◽

2020 ◽

Author(s):

zouheir bitar ◽

Mohammed Shamsah ◽

Omar Bamasood ◽

Ossama Maadrani ◽

Huda Al foudri

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Left Ventricular ◽

Circulatory Failure ◽

Left Ventricular Ejection ◽

P Value ◽

Point Of Care Ultrasound ◽

Rt Pcr ◽

Ventricular Ejection Fraction ◽

Hemodynamic Assessment

Abstract BackgroundPoint-of-care ultrasound (POCUS) has a major role in the management of patients with acute hypoxic respiratory and circulatory failure and guides hemodynamic management. There is scarce literature on POCUS assessment characteristics in COVID-19 pneumonia with hypoxic respiratory failure.MethodsThe study is an observational, prospective, single‐center study conducted in the intensive care unit of Adan General Hospital from May 1st, 2020, to June 25, 2020. The study included adults suspected to have COVID-19 transferred to the intensive care unit (ICU) with fever or suspected respiratory infection. Patients were transferred to the ICU directly from the ED or general medical wards after reverse transcriptase-polymerase chain reaction (RT-PCR) testing. A certified intensivist in critical care ultrasound who was blinded to the RT-PCR results, if available at the time of examination, performed the lung ultrasound and echocardiology within 12 hours of the patient’s admission to the ICU. We calculated the E/e’, E/A ratio, left ventricular ejection fraction EF, IVC diameter, RV size and systolic function. We performed ultrasound in 12 chest areas.ResultsOf 92 patients with suspected COVID-19 pneumonia, 77 (84%) cases were confirmed. The median age of the patients was 53 (82-36) years, and 71 (77%) were men.In the group of patients with confirmed COVID-19 pneumonia, echocardiographic findings showed normal E/e’, deceleration time (DT), and transmittal E/A ratio in comparison to the non-COVID19 patients (P .001 for both). The IVC diameter was <2 cm with > 50% collapsibility in 62 (81%) patients with COVID-19 pneumonia; a diameter of > 2 cm and < 50% collapsibility in all patients, with a P value of 0.001, was detected among those with non-COVID-19 pneumonia. There were 3 cases of myocarditis with poor EF (5.5%), severe RV dysfunction was seen in 9 cases (11.6%), and 3 cases showed RV thrombus.Chest US revealed four signs suggestive of COVID-19 pneumonia in 77 patients (98.6%) (sensitivity 96.9%, CI 85%‐99.5%) when compared with RT-PCR results.ConclusionPOCUS plays an important role in bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure in patients with COVID-19 pneumonia.

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