Erik Andreas Rye Berg, Anders Austlid Taskén, Trym Nordal, Bjørnar Grenne, Torvald Espeland, Idar Kirkeby-Garstad, Håvard Dalen, Espen Holte, Stian Stølen, Svend Aakhus, Gabriel Kiss
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引用次数: 0
Abstract
Aims: To improve monitoring of cardiac function during major surgery and intensive care, we have developed a method for fully automatic estimation of mitral annular plane systolic excursion (auto-MAPSE) using deep learning in transoesophageal echocardiography (TOE). The aim of this study was a clinical validation of auto-MAPSE in patients with heart disease.
Methods and results: TOE recordings were collected from 185 consecutive patients without selection on image quality. Deep-learning-based auto-MAPSE was trained and optimized from 105 patient recordings. We assessed auto-MAPSE feasibility, and agreement and inter-rater reliability with manual reference in 80 patients with and without electrocardiogram (ECG) tracings. Mean processing time for auto-MAPSE was 0.3 s per cardiac cycle/view. Overall feasibility was >90% for manual MAPSE and ECG-enabled auto-MAPSE and 82% for ECG-disabled auto-MAPSE. Feasibility in at least two walls was ≥95% for all methods. Compared with manual reference, bias [95% limits of agreement (LoA)] was -0.5 [-4.0, 3.1] mm for ECG-enabled auto-MAPSE and -0.2 [-4.2, 3.6] mm for ECG-disabled auto-MAPSE. Intra-class correlation coefficient (ICC) for consistency was 0.90 and 0.88, respectively. Manual inter-observer bias [95% LoA] was -0.9 [-4.7, 3.0] mm, and ICC was 0.86.
Conclusion: Auto-MAPSE was fast and highly feasible. Inter-rater reliability between auto-MAPSE and manual reference was good. Agreement between auto-MAPSE and manual reference did not differ from manual inter-observer agreement. As the principal advantages of deep-learning-based assessment are speed and reproducibility, auto-MAPSE has the potential to improve real-time monitoring of left ventricular function. This should be investigated in relevant clinical settings.
期刊介绍:
Launched in 1991, Psychoanalytic Dialogues was founded on the premise that within the diverse world of psychoanalysis there had developed a set of overlapping perspectives that regarded relational configurations of self and others, real and fantasied, as the primary units of human motivation and psychodynamic explanation. These perspectives emerged within interpersonal psychoanalysis; British objct relations theories; self psychology; the empirical traditions of infancy research and child development; and certain currents of contemporary Freudian thought. This common relational model has come to provide a vitalizing framework within which clinical contributions can be situated and developed.