Continuous monitoring of left ventricular function in postoperative intensive care patients using artificial intelligence and transesophageal echocardiography.

IF 2.8 Q2 CRITICAL CARE MEDICINE
Jinyang Yu, Anders Austlid Taskén, Erik Andreas Rye Berg, Tomas Dybos Tannvik, Katrine Hordnes Slagsvold, Idar Kirkeby-Garstad, Bjørnar Grenne, Gabriel Kiss, Svend Aakhus
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引用次数: 0

Abstract

Background: Continuous monitoring of mitral annular plane systolic excursion (MAPSE) using transesophageal echocardiography (TEE) may improve the evaluation of left ventricular (LV) function in postoperative intensive care patients. We aimed to assess the utility of continuous monitoring of LV function using TEE and artificial intelligence (autoMAPSE) in postoperative intensive care patients.

Methods: In this prospective observational study, we monitored 50 postoperative intensive care patients for 120 min immediately after cardiac surgery. We recorded a set of two-chamber and four-chamber TEE images every five minutes. We defined monitoring feasibility as how often the same wall from the same patient could be reassessed, and categorized monitoring feasibility as excellent if the same LV wall could be reassessed in ≥ 90% of the total recordings. To compare autoMAPSE with manual measurements, we rapidly recorded three sets of repeated images to assess precision (least significant change), bias, and limits of agreement (LOA). To assess the ability to identify changes (trending ability), we compared changes in autoMAPSE with the changes in manual measurements in images obtained during the initiation of cardiopulmonary bypass as well as before and after surgery.

Results: Monitoring feasibility was excellent in most patients (88%). Compared with manual measurements, autoMAPSE was more precise (least significant change 2.2 vs 3.1 mm, P < 0.001), had low bias (0.4 mm), and acceptable agreement (LOA - 2.7 to 3.5 mm). AutoMAPSE had excellent trending ability, as its measurements changed in the same direction as manual measurements (concordance rate 96%).

Conclusion: Continuous monitoring of LV function was feasible using autoMAPSE. Compared with manual measurements, autoMAPSE had excellent trending ability, low bias, acceptable agreement, and was more precise.

利用人工智能和经食道超声心动图持续监测术后重症监护患者的左心室功能。
背景:使用经食道超声心动图(TEE)连续监测二尖瓣环平面收缩期偏移(MAPSE)可改善术后重症监护患者的左心室(LV)功能评估。我们旨在评估利用 TEE 和人工智能(autoMAPSE)对术后重症监护患者的左心室功能进行连续监测的效用:在这项前瞻性观察研究中,我们对 50 名术后重症监护患者在心脏手术后立即进行了 120 分钟的监测。我们每五分钟记录一组两腔和四腔 TEE 图像。我们将监测可行性定义为重新评估同一患者同一心室壁的频率,如果在总记录中重新评估同一左心室壁的次数≥ 90%,则将监测可行性归类为极佳。为了将 autoMAPSE 与人工测量进行比较,我们快速记录了三组重复图像,以评估精确度(最小显著变化)、偏差和一致性极限 (LOA)。为了评估识别变化的能力(趋势能力),我们比较了心肺旁路术开始时以及手术前后图像中自动 MAPSE 的变化和人工测量的变化:大多数患者(88%)的监测可行性都非常好。与人工测量相比,autoMAPSE 更为精确(最小显著性变化为 2.2 mm vs 3.1 mm,P 结论:autoMAPSE 是一种可持续监测左心室功能的方法:使用 autoMAPSE 对左心室功能进行连续监测是可行的。与人工测量相比,autoMAPSE 具有出色的趋势分析能力、低偏差、可接受的一致性和更高的精确度。
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来源期刊
Intensive Care Medicine Experimental
Intensive Care Medicine Experimental CRITICAL CARE MEDICINE-
CiteScore
5.10
自引率
2.90%
发文量
48
审稿时长
13 weeks
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