Artificial Intelligence as a Business Partner in Cardiovascular Precision Medicine: an Emerging Approach for Disease Detection and Treatment Optimization

2020 ◽  
Vol 28 ◽  
Author(s):  
Valeria Visco ◽  
Germano Junior Ferruzzi ◽  
Federico Nicastro ◽  
Nicola Virtuoso ◽  
Albino Carrizzo ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Precision Medicine ◽  
Clinical Decision Making ◽  
Disease Detection ◽  
Physician Patient Relationship ◽  
Invasive Approach ◽  
Tailored Treatment ◽  
The Impact

Background: In the real world, medical practice is changing hand in hand with the development of new Artificial Intelligence (AI) systems and problems from different areas have been successfully solved using AI algorithms. Specifically, the use of AI techniques in setting up or building precision medicine is significant in terms of the accuracy of disease discovery and tailored treatment. Moreover, with the use of technology, clinical personnel can deliver a very much efficient healthcare service. Objective: This article reviews AI state-of-the-art in cardiovascular disease management, focusing on diagnostic and therapeutic improvements. Methods: To that end, we conducted a detailed PubMed search on AI application from distinct areas of cardiology: heart failure, arterial hypertension, atrial fibrillation, syncope and cardiovascular rehabilitation. Particularly, to assess the impact of these technologies in clinical decision-making, this research considers technical and medical aspects. Results: On one hand, some devices in heart failure, atrial fibrillation and cardiac rehabilitation represent an inexpensive, not invasive or not very invasive approach to long-term surveillance and management in these areas. On the other hand, the availability of large datasets (big data) is a useful tool to predict the development and outcome of many cardiovascular diseases. In summary, with this new guided therapy, the physician can supply prompt, individualised, and tailored treatment and the patients feel safe as they are continuously monitored, with a significant psychological effect. Conclusion: Soon, tailored patient care via telemonitoring can improve the clinical practice because AI-based systems support cardiologists in daily medical activities, improving disease detection and treatment. However, the physician-patient relationship remains a pivotal step.

Atrial fibrillation and congestive heart failure: what is the impact of long-term anticoagulation on outcomes

2004 ◽  
Vol 10 (4) ◽  
pp. S110
Author(s):  
Lynn G. Tarkington ◽  
Salvatore L. Battaglia ◽  
April W. Simon ◽  
Steven D. Culler ◽  
Edmund R. Becker ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
The Impact

scholarly journals Cardiovascular risk after hospitalisation for unexplained syncope and orthostatic hypotension

Heart ◽  
2017 ◽  
Vol 104 (6) ◽  
pp. 487-493 ◽  
Author(s):  
Ekrem Yasa ◽  
Fabrizio Ricci ◽  
Martin Magnusson ◽  
Richard Sutton ◽  
Sabina Gallina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Orthostatic Hypotension ◽  
Cardiovascular Events ◽  
Hospital Admissions ◽  
Cox Regression ◽  
All Cause Mortality ◽  
Unexplained Syncope ◽  
The Impact

ObjectiveTo investigate the relationship of hospital admissions due to unexplained syncope and orthostatic hypotension (OH) with subsequent cardiovascular events and mortality.MethodsWe analysed a population-based prospective cohort of 30 528 middle-aged individuals (age 58±8 years; males, 40%). Adjusted Cox regression models were applied to assess the impact of unexplained syncope/OH hospitalisations on cardiovascular events and mortality, excluding subjects with prevalent cardiovascular disease.ResultsAfter a median follow-up of 15±4 years, 524 (1.7%) and 504 (1.7%) participants were hospitalised for syncope or OH, respectively, yielding 1.2 hospital admissions per 1000 person-years for each diagnosis. Syncope hospitalisations increased with age (HR, per 1 year: 1.07, 95% CI 1.05 to 1.09), higher systolic blood pressure (HR, per 10 mm Hg: 1.06, 95% CI 1.01 to 1.12), antihypertensive treatment (HR: 1.26, 95% CI 1.00 to 1.59), use of diuretics (HR: 1.77, 95% CI 1.31 to 2.38) and prevalent cardiovascular disease (HR: 1.59, 95% CI 1.14 to 2.23), whereas OH hospitalisations increased with age (HR: 1.11, 95% CI 1.08 to 1.12) and prevalent diabetes (HR: 1.82, 95% CI 1.23 to 2.70). After exclusion of 1399 patients with prevalent cardiovascular disease, a total of 473/464 patients were hospitalised for unexplained syncope/OH before any cardiovascular event. Hospitalisation for unexplained syncope predicted coronary events (HR: 1.85, 95% CI 1.49 to 2.30), heart failure (HR: 2.24, 95% CI 1.65 to 3.04), atrial fibrillation (HR: 1.84, 95% CI 1.50 to 2.26), aortic valve stenosis (HR: 2.06, 95% CI 1.28 to 3.32), all-cause mortality (HR: 1.22, 95% CI 1.09 to 1.37) and cardiovascular death (HR: 1.72, 95% CI 1.23 to 2.42). OH-hospitalisation predicted stroke (HR: 1.66, 95% CI 1.24 to 2.23), heart failure (HR: 1.78, 95% CI 1.21 to 2.62), atrial fibrillation (HR: 1.89, 95% CI 1.48 to 2.41) and all-cause mortality (HR: 1.14, 95% CI 1.01 to 1.30).ConclusionsPatients discharged with the diagnosis of unexplained syncope or OH show higher incidence of cardiovascular disease and mortality with only partial overlap between these two conditions.

Abstract P369: Polypharmacy, Adverse Outcomes, and Treatment Effectiveness in Elderly Patients With Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Aniqa Alam ◽  
Nemin Chen ◽  
Pamela L Lutsey ◽  
Richard MacLehose ◽  
J'Neka Claxton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Rate Control ◽  
Treatment Effectiveness ◽  
Adverse Outcomes ◽  
Pharmacy Claims ◽  
Increased Risk ◽  
The Impact

Background: Polypharmacy is highly prevalent in elderly individuals with chronic conditions, including atrial fibrillation (AF). The impact of polypharmacy on adverse outcomes and on treatment effectiveness in elderly AF patients remains unaddressed. Methods: We studied 338,810 AF patients ≥75 years of age with 1,761,660 active prescriptions [mean (SD), 5.1 (3.8) per patient] enrolled in the MarketScan Medicare Supplemental database in 2007-2015. Polypharmacy was defined as ≥5 active prescriptions at AF diagnosis based on outpatient pharmacy claims. AF treatments (oral anticoagulation, rhythm and rate control) and cardiovascular endpoints (ischemic stroke, bleeding, heart failure) were defined based on inpatient, outpatient and pharmacy claims. Multivariable Cox models were used to estimate associations of polypharmacy with cardiovascular endpoints and the interaction between polypharmacy and AF treatments in relation to cardiovascular endpoints. Results: Prevalence of polypharmacy was 52% (176,007 of 338,810). Patients with polypharmacy had increased risk of major bleeding [hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.12, 1.20] and heart failure (HR 1.33, 95%CI 1.29, 1.36), but not of ischemic stroke (HR 0.96, 95%CI 0.92, 1.00), compared to those not with polypharmacy (Table). Polypharmacy status did not consistently modify the effectiveness of oral anticoagulants. However, rhythm control (vs. rate control) was more effective in preventing heart failure hospitalization in patients not with polypharmacy (HR 0.87, 95%CI 0.76, 0.99) than among those with polypharmacy (HR 0.98, 95%CI 0.91, 1.07, p for interaction = 0.02). Conclusion: Polypharmacy is frequent among elderly patients with AF, associated with adverse outcomes, and potentially affecting the effectiveness of AF treatments. Optimizing management of polypharmacy in elderly AF patients may lead to improved outcomes.

scholarly journals Artificial Intelligence Predicts Atrial Fibrillation Development from the 12-lead Electrocardiogram in Heart Failure with Preserved Ejection Fraction

2020 ◽  
Vol 26 (10) ◽  
pp. S76
Author(s):  
Frederik Hendrik Verbrugge ◽  
Yogesh N.V. Reddy ◽  
Zachi I. Attia ◽  
Paul A. Friedman ◽  
Peter A. Noseworthy ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Preserved Ejection Fraction

scholarly journals Increased left atrial pressure in non-heart failure patients with subclinical hypothyroidism and atrial fibrillation

2016 ◽  
Vol 5 (3) ◽  
pp. 101-106 ◽  
Author(s):  
Akinori Sairaku ◽  
Yukiko Nakano ◽  
Yuko Uchimura ◽  
Takehito Tokuyama ◽  
Hiroshi Kawazoe ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Subclinical Hypothyroidism ◽  
Left Atrial ◽  
Structural Heart Disease ◽  
Thyroid Stimulating Hormone ◽  
The Mean ◽  
V Wave ◽  
The Impact ◽  
The Relationship

Background The impact of subclinical hypothyroidism on the cardiovascular risk is still debated. We aimed to measure the relationship between subclinical hypothyroidism and the left atrial (LA) pressure. Methods The LA pressures and thyroid function were measured in consecutive patients undergoing atrial fibrillation (AF) ablation, who did not have any known heart failure, structural heart disease, or overt thyroid disease. Results Subclinical hypothyroidism (4.5≤ thyroid-stimulating hormone <19.9 mIU/L) was present in 61 (13.0%) of the 471 patients included. More subclinical hypothyroidism patients than euthyroid patients (55.7% vs 40.2%; P=0.04).’euthyroid patients had persistent or long-standing persistent AF (55.7% vs 40.2%; P = 0.04). The mean LA pressure (10.9 ± 4.7 vs 9.1 ± 4.3 mmHg; P = 0.002) and LA V-wave pressure (17.4 ± 6.5 vs 14.3 ± 5.9 mmHg; P < 0.001) were, respectively, higher in the patients with subclinical hypothyroidism than in the euthyroid patients. After an adjustment for potential confounders, the LA pressures remained significantly higher in the subclinical hypothyroidism patients. A multiple logistic regression model showed that subclinical hypothyroidism was independently associated with a mean LA pressure of >18 mmHg (odds ratio 3.94, 95% CI 1.28 11.2; P = 0.02). Conclusions Subclinical hypothyroidism may increase the LA pressure in AF patients.

scholarly journals The impact of catheter ablation for atrial fibrillation in heart failure

2018 ◽  
Vol 35 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Konstantinos Moschonas ◽  
Adam Nabeebaccus ◽  
Darlington O. Okonko ◽  
Theresa A. McDonagh ◽  
Francis D. Murgatroyd ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
The Impact

scholarly journals Evaluation of the impact of atrial fibrillation on rehospitalization events in heart failure patients in recent years

2012 ◽  
Vol 60 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Masami Murakami ◽  
Shinichi Niwano ◽  
Toshimi Koitabashi ◽  
Takayuki Inomata ◽  
Akira Satoh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Failure Patients ◽  
The Impact

scholarly journals Precision Medicine in the Context of Artificial Intelligence

2019 ◽  
Author(s):  
Rehab A. Rayan
Keyword(s):  
Artificial Intelligence ◽  
Precision Medicine ◽  
Clinical Decision Making ◽  
Decision Support Techniques ◽  
Initial Step ◽  
Clinical Decision ◽  
Moral Accountability ◽  
Legal Obligations ◽  
Ibm Watson ◽  
Selection Of

Similar to all fields of study, growth occurs with breakthrough or developmental research spanning to the progress and intimate utility of technology. Dilemmas of various sectors have been favorably resolved by adopting artificial intelligence (AI) algorithms. Applying Precision Medicine profoundly depends on AI algorithms to work Precision Medicine queries like; predicting or detecting, diagnosing the disease properly, and optimizing therapy, hence, the selection of the algorithm is affected by its capacity and practicality. Nevertheless, it is yet in its initial step and fronts some hurdles crucial to the flourishing deployment of precision medicine like research, adoption values, and authority controls. Notwithstanding, Precision Medicine also pretends some difficulties like; modifying the health discipline and profession to the fact that automata and algorithms could displace most of the healthcare professional tasks they act now. Ultimately, effective employment of precision medicine would rescue countless lives and improve the health profession. This review examines the present state of AI applications in precision medicine and future opportunities. It discusses major AI systems like IBM Watson, examining moral accountability and legal obligations when applying it in clinical decision-making, advantages and boundaries of employing Watson and different AI clinical decision support techniques, and considerations before consulting AI systems.

scholarly journals Impact of rate control medications on one-year outcomes with atrial fibrillation and heart failure

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R Mo ◽  
Y Yang ◽  
L Yu
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Adverse Events ◽  
Rate Control ◽  
Cardiovascular Death ◽  
Control Treatment ◽  
All Cause Mortality ◽  
One Year ◽  
Cox Analysis ◽  
The Impact

Abstract Purpose Atrial fibrillation (AF) and heart failure (HF) often coexist. The impact of rate-control regimens in AF and HF patients has not been well understood. Methods In this multicenter, prospective registry with one-year follow-up, 1359 persistent or permanent AF patients got enrolled. A 1:1 HF to non-HF propensity score matching was applied to adjust for confounding variables. The primary endpoint was all-cause mortality while the secondary endpoint was defined as cardiovascular death and stroke. Multivariate Cox analysis was performed to evaluate the association between different rate-control treatment and incidence of adverse events. Results Before matching, HF patients were much younger and more likely to be female. They had a much higher prevalence of previous myocardial infarction, chronic obstructive pulmonary disease and valvular heart disease. Among 1359 participants, we identified 1016 matched patients. The number of drugs did not affect the risk of all-cause mortality in both cohorts. For non-HF patients, using calcium channel blockers (CCBs) plus digoxin had a significant higher risk of all-cause death (HR=5.703, 95% CI 1.334–24.604, p=0.019) and cardiovascular death (HR=9.558, 95% CI 2.127–42.935, p=0.003) compared with patients not receiving rate-control treatment. The use of beta-blockers, CCBs, digoxin alone, other dual or triple combinations was not related to risk of adverse events in both groups. Conclusions The combined use of CCBs and digoxin was related to increase all-cause and cardiovascular mortality in AF patients without HF but not for those with HF. However, the ideal rate-control regimen for AF and HF patients has not been established and well-designed clinical trials are needed. FUNDunding Acknowledgement Type of funding sources: None. Results of multivariate Cox analysis Kaplan-Meier curves by drug numbers

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