Analysis and classification of myocardial tissue after myocardial infarction using wavelet image decomposition

Introduction: The majority of population-based studies of myocardial infarction (MI) rely on billing codes for classification. Classification algorithms employing machine learning (ML) increasingly used for phenotyping using electronic health record (EHR) data. Hypothesis: ML algorithms integrating billing and information from narrative notes extracted using natural language processing (NLP) can improve classification of MI compared to billing code algorithms. Improved classification will improve power to compare risk factors across population subgroups. Methods: Retrospective cohort study of nationwide Veterans Affairs (VA) EHR data. MI classified using 2 approaches: (1) published billing code algorithm, (2) published phenotyping pipeline incorporating NLP and ML. Results compared against gold standard chart review of MI outcomes in 308 Veterans. We also tested known association between high density lipoprotein cholesterol (HDL-C) and MI outcomes classified using the 2 approaches among Black and White Veterans, stratified by sex and race; prior study showed HDL-C less protective for Black compared to White individuals. Results: We studied 17,176,658 million Veterans, mean age 69 years, 94% male, 12% self-report Black, 71% White. The billing code algorithm classified MI at positive predictive value (PPV) 0.64 compared to the published ML approach, PPV 0.90; the latter classified a modestly higher percentage of non-White Veterans. Using ML algorithm for MI, we replicated a reduced protective effect of HDL-C in Black vs White male and female Veterans (Table); with the billing code algorithm no association was observed between low density lipoprotein cholesterol (LDL-C) or HDL-C with MI among Black female Veterans. Conclusions: Using nationwide VA data, application of an ML approach improved classification of MI particularly among non-White Veterans, resulting in improved power to study differences in association for MI risk factors among Black and White Veterans.

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Comparison of myocardial tissue-reperfusion of inferior wall and a right ventricle among patients after primary angioplasty for an inferior myocardial infarction with right ventricular infarction

Minerva Cardiology and Angiology ◽

10.23736/s0026-4725.20.05223-8 ◽

2020 ◽

Author(s):

Michał ŚWIERCZEWSKI ◽

Edyta KACZMARSKA ◽

Rajmund BOBROWSKI ◽

Kamil ZIELIŃSKI ◽

Jerzy PRĘGOWSKI ◽

...

Keyword(s):

Myocardial Infarction ◽

Right Ventricle ◽

Right Ventricular ◽

Primary Angioplasty ◽

Myocardial Tissue ◽

Inferior Wall ◽

Inferior Myocardial Infarction ◽

Right Ventricular Infarction ◽

Ventricular Infarction

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The Mechanism of Rhein Ameliorating the Survival Rate of Transplanted Mesenchymal Stem Cells by Improving Myocardial Microenvironment in Acute Myocardial Infarction

Journal of Biomaterials and Tissue Engineering ◽

10.1166/jbt.2021.2570 ◽

2021 ◽

Vol 11 (4) ◽

pp. 684-689

Author(s):

Xuejun Deng ◽

Xiaojun He ◽

Gang Huang ◽

Dongmei Yu ◽

Xiaozhen Lin

Keyword(s):

Myocardial Infarction ◽

Stem Cells ◽

Survival Rate ◽

Heart Function ◽

Immunofluorescence Staining ◽

Inflammatory Factors ◽

Tunel Staining ◽

Myocardial Tissue ◽

Tnf Α ◽

Myocardial Fibers

Background: The paper investigated the mechanism of Rhein improving the ischemic myocardial microenvironment, promoting the survival rate of transplanted BMSCs and functional recovery of damaged myocardium by alleviating myocardial ERS-mediated hyperinflammation and apoptosis after AMI. Material and Methods: A model of myocardial infarction was established. BLI was used to detect the survival rate of transplanted stem cells at 1, 7, 14, 21 and 28 days after surgery. TUNEL staining was used to assess apoptosis. ERS-related protein CHOP immunofluorescence staining was used to assess ERS level. The expressions of ERS-related biomarkers ATF4, CHOP, GRP78 and GRP94 were detected by Western Blot. The inflammatory factors IL-6, TNF-α and IL- 10 of myocardial tissue were detected by ELISA. CD31 immunization was performed 28 days after surgery. Fluorescence staining was used to assess tissue angiogenesis. Results: Rhein combined with BMSCs could improve cardiac function, decrease apoptosis and myocardial CHOP expression. WB showed that the expressions of ATF4, CHOP, GRP78 and GRP94 in myocardial tissue of MI rats were decreased. ELISA showed that Rhein can inhibit the expressions of pro-inflammatory factors IL-6 and TNF-α, and promote anti-inflammatory factors IL-10 expression. CD31 immunofluorescence staining showed that Rhein can promote the formation of neovascularization in infarcted myocardium. Conclusion: In AMI, myocardial ERS is activated. Rhein inhibits ERS and the mediated inflammation and oxidative stress after AMI, inhibits apoptosis, improves the survival rate of transplanted BMSCs, enhances BMSCs to promote neovascularization, inhibits myocardial fibers, and improves heart function.

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Ischaemic heart disease in women

ESC CardioMed ◽

10.1093/med/9780198784906.003.0679 ◽

2018 ◽

pp. 2836-2840

Author(s):

Martha Gulati

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Heart Disease ◽

Coronary Artery ◽

Ischaemic Heart Disease ◽

Obstructive Coronary Artery Disease ◽

Diagnostic Testing ◽

Atypical Presentation ◽

Artery Disease

The more atypical presentation of women makes the diagnostic evaluation of symptomatic women challenging and results in more frequent referral for diagnostic testing to improve the precision of the ischaemic heart disease likelihood estimate. The classification of ischaemic heart disease and myocardial infarction has moved beyond the diagnosis of obstructive coronary artery disease and encompasses ischaemia that can occur in the presence and absence of obstructive coronary artery disease. Consideration of the different pathophysiology of ischaemia that may occur in women needs to be considered in the evaluation and treatment of ischaemic heart disease in women.

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