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AI Algorithm Estimates LVEF from Angiograms


Core Concepts
AI algorithm estimates LVEF from angiograms accurately.
Abstract
The study introduces a novel AI algorithm, CathEF, that estimates left ventricular ejection function (LVEF) from angiogram videos. The algorithm shows promise in discriminating reduced LVEF with high accuracy. The study aims to enhance trust in AI-driven predictions among healthcare professionals by providing transparent information on model training and validation. The research highlights the potential of AI in real-time assessment of cardiac function during coronary angiography, potentially improving patient outcomes and quality of life.
Stats
In the test dataset, the DNN discriminated reduced LVEF (<40%) with an AUROC of 0.911. The DNN discriminated reduced LVEF with an AUROC of 0.906 in the external validation dataset. The CathEF-predicted LVEF had a mean absolute error (MAE) of 8.5% compared with TTE LVEF.
Quotes
"We know the findings will be unexpected for cardiologists who don't typically expect to get an estimate of systolic function or pump function just from an angiogram." - Geoffrey H. Tison, MD

Key Insights Distilled From

by Marilynn Lar... at www.medscape.com 05-15-2023

https://www.medscape.com/viewarticle/991966
Video-Based AI Tool Estimates LVEF From Angiograms

Deeper Inquiries

How can AI algorithms like CathEF be further improved to enhance their clinical utility?

To enhance the clinical utility of AI algorithms like CathEF, several improvements can be considered. Firstly, increasing the diversity and size of the training datasets can help improve the algorithm's accuracy and generalizability. By including a broader range of patient demographics, comorbidities, and clinical scenarios, the algorithm can better adapt to real-world variations. Additionally, refining the algorithm's architecture and fine-tuning its parameters through continuous learning and feedback loops can optimize its performance. Collaborating with clinicians to incorporate their expertise and feedback can also refine the algorithm's predictive capabilities and ensure its alignment with clinical practice. Moreover, conducting further validation studies across different patient populations and healthcare settings can validate the algorithm's reliability and effectiveness in diverse clinical scenarios.

Is there a risk of overestimating LVEF in patients with severely reduced function, and how can this be mitigated?

There is indeed a risk of overestimating LVEF in patients with severely reduced function when using AI algorithms like CathEF. This overestimation can occur due to the algorithm's training on a specific dataset that may not fully represent the variability and complexity of all patient populations. To mitigate this risk, several strategies can be implemented. One approach is to incorporate additional features or parameters into the algorithm that specifically address the challenges of accurately estimating LVEF in patients with severely reduced function. By fine-tuning the algorithm's predictive model to account for these specific scenarios, the risk of overestimation can be minimized. Furthermore, conducting targeted validation studies focusing on patients with severely reduced LVEF can help identify and address any potential biases or inaccuracies in the algorithm's predictions.

How might real-time assessment of cardiac function during coronary angiography impact treatment decisions in acute cases?

Real-time assessment of cardiac function during coronary angiography can have a significant impact on treatment decisions in acute cases, particularly in scenarios like acute ST-segment elevation myocardial infarction (STEMI). By providing immediate and dynamic information on cardiac function, clinicians can make timely and informed decisions regarding treatment strategies. For instance, in cases where baseline cardiac function and renal function are unknown, real-time assessment can guide the selection of appropriate therapies and interventions. Additionally, the ability to assess cardiac function during angiography can help identify patients who may benefit from early interventions or therapies, leading to potentially improved outcomes and quality of life. This real-time assessment can also be valuable in cases where additional contrast may be detrimental, as it allows for the optimization of treatment approaches based on real-time physiological data.
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