IJC Heart and Vasculature最新文献

{"title":"Transcatheter or surgical treatment of paravalvular leaks: A meta-analysis of 13 studies and 2003 patients","authors":"Riccardo Improta ,&nbsp;Gianluca Di Pietro ,&nbsp;Yasser Odeh ,&nbsp;Arianna Morena ,&nbsp;Wael Saade ,&nbsp;Fabrizio D’Ascenzo ,&nbsp;Massimo Mancone ,&nbsp;Fabio Miraldi","doi":"10.1016/j.ijcha.2024.101583","DOIUrl":"10.1016/j.ijcha.2024.101583","url":null,"abstract":"<div><h3>Background</h3><div>Significant paravalvular leak is a rare but serious complication of heart valve replacement, leading to symptomatic heart failure and hemolysis. Due to the paucity of comparative data between surgical and transcatheter paravalvular leak correction, we performed a systematic review and meta-analysis of available studies.</div></div><div><h3>Methods</h3><div>Studies comparing transcatheter and surgical treatment of paravalvular leak were systematically identified. Short-term all-cause mortality was the primary outcome. Technical and procedural success, 30-day persistence of significant paravalvular leak, length of hospital stay and long-term mortality, persistence of symptoms and paravalvular leak were the main secondary endpoints.</div></div><div><h3>Results</h3><div>Thirteen studies with 2003 patients were included, treating in most of the cases a mitral prothesis. Transcatheter closure was associated with lower short-term mortality rate (30 days OR 0.28, 95 % CI 0.18–0.42, p &lt; 0.001) compared to surgical treatment. Technical and procedural success did not differ among the two groups. 30-day and long-term rates of persistence of moderate or severe paravalvular leak were higher in the transcatheter group (OR 3.56, 95 % CI 1.49–8.49, p = 0.004 and OR 2.20, 95 % CI 1.27–3.81, p = 0.005 respectively). Long-term death and re-hospitalization events did not differ among the two treatment modalities. The mean difference in days of length of stay was significantly lower in the transcatheter group (mean difference −9.66, 95 % CI −12.37 to −6.94, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Transcatheter closure of paravalvular leaks is associated with lower short-term mortality rates but higher persistence of moderate-severe paravalvular leak and heart failure symptoms at short and long-term follow-up compared to surgical treatment.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101583"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of coronary microvascular dysfunction in patients with myocardial infarction evaluated by new angiography-derived index of microvascular resistance","authors":"Benoit Caullery ,&nbsp;Laurent Riou ,&nbsp;Stephanie Marliere ,&nbsp;Estelle Vautrin ,&nbsp;Nicolas Piliero ,&nbsp;Olivier Ormerzzano ,&nbsp;Helene Bouvaist ,&nbsp;Gerald Vanzetto ,&nbsp;Gilles Barone-Rochette","doi":"10.1016/j.ijcha.2024.101575","DOIUrl":"10.1016/j.ijcha.2024.101575","url":null,"abstract":"<div><h3>Background</h3><div>Several methods for measuring IMR derived from angiography have been developed. AngioIMR is a novel method for the assessment of angiography-derived IMR with no requirement for a wire and hyperemia. The prognostic value of AngioIMR is unknown in STEMI patients. We aimed to provide the prognostic value of AngioIMR in patients with ST-elevation myocardial infarction (STEMI).</div></div><div><h3>Methods</h3><div>This study included patients with STEMI who underwent invasive coronary angiography and primary percutaneous coronary intervention (PPCI). AngioIMR was calculated using computational flow and pressure simulation immediately after PPCI. The presence of significant coronary microvascular dysfunction was defined as AngioIMR &gt; 40. The primary outcome was a composite of all cause death or hospitalization for heart failure (MACE).</div></div><div><h3>Results</h3><div>A total of 178 patients were included (65.0 ± 12.8 years on average, 74 % male gender). An AngioIMR &gt; 40 was found in 72 patients. During a median follow-up of 2.9 (2.3–6.9) years, a primary endpoint was observed in 56 patients. By Kaplan-Meier analysis, the risk of MACE was significantly higher in patients with AngioIMR &gt; 40 (log-rank P &lt; 0.01). An Angio IMR &gt; 40 was significantly associated with the occurrence of the primary endpoint in univariate (70 % vs 27 %; hazard ratio 4.519; 95 % CI: 2.550–8.009; p &lt; 0.0001) and multivariate analysis (Hazard ratio 4.282; 95 % CI: 2.325–7.886; p &lt; 0.0001). AngioIMR model showed incremental prognostic value compared to a model with clinical and imaging risk predictors (C-index 0.84 vs 0.79; p = 0.04).</div></div><div><h3>Conlusion</h3><div>Elevated AngioIMR showed a independent prognostic significance in STEMI patients. In addition to well-known risk factors, assessment of coronary microvascular dysfunction can be a feasible approach for early prevention and a therapeutic target in STEMI patients.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101575"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct oral anticoagulants in deep vein thrombosis associated with inferior vena cava agenesis: A report of three cases and a systematic review","authors":"Nicola Osti ,&nbsp;Vito Racanelli ,&nbsp;Nicola Susca ,&nbsp;Nicola Martinelli ,&nbsp;Alberto Maino","doi":"10.1016/j.ijcha.2024.101565","DOIUrl":"10.1016/j.ijcha.2024.101565","url":null,"abstract":"<div><h3>Background</h3><div>Inferior vena cava agenesis (IVCA) is a rare vascular abnormality characterised by the absence of one or more segments of the inferior vena cava and represents an underestimated cause of deep vein thrombosis (DVT). Given the very low prevalence of this condition and the lack of clinical trials, there is no consensus about the optimal anticoagulation strategy in IVCA-associated DVT.</div></div><div><h3>Objectives</h3><div>To investigate efficacy and safety of direct oral anticoagulants (DOACs) in IVCA-associated DVT.</div></div><div><h3>Methods</h3><div>We described three patients with IVCA-associated DVT followed at our Institution and treated with DOACs. Then, we performed a systematic review of the literature for ICVA-associated DVT treated with DOACs.</div></div><div><h3>Results</h3><div>In addition to our 3 cases, we found data from 19 publications for a total of 30 patients with IVCA-associated DVT treated with DOACs (24 subjects treated with rivaroxaban, 8 with apixaban, and one with dabigatran). Most patients were males (72.7 %) with a median age at DVT onset of 26.0 years (min–max range 13–64 years). The majority of DVT events were unprovoked (76.0 %). The standard thrombophilia tests were mainly negative. The median follow-up period during DOAC therapy was 1.0 years (min–max range 0–10 years), with one recurrent splanchnic vein thrombosis reported and no haemorrhagic events.</div></div><div><h3>Conclusions</h3><div>IVCA is a rare cause of DVT, which should be suspected in young adults with unprovoked DVT. Although future studies are needed, available data may support the use of DOACs in IVCA-associated DVT, with a reassuring profile of both efficacy and safety.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101565"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the landscape of tricuspid regurgitation with transcatheter tricuspid valve replacement","authors":"Muhammad Adnan Zaman","doi":"10.1016/j.ijcha.2024.101577","DOIUrl":"10.1016/j.ijcha.2024.101577","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101577"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis of pulmonary hypertension in patients with hypertrophic cardiomyopathy: A multicenter propensity score matching study","authors":"Huihui Ma ,&nbsp;Fengcheng Xu ,&nbsp;Lei Liu ,&nbsp;Hong Kong ,&nbsp;Rong Luo ,&nbsp;Mingjiang Liu ,&nbsp;Tianhu Liu ,&nbsp;Xiaoping Li","doi":"10.1016/j.ijcha.2025.101605","DOIUrl":"10.1016/j.ijcha.2025.101605","url":null,"abstract":"<div><h3>Objectives</h3><div>Pulmonary hypertension (PH) is known to be associated with increased mortality in patients suffering from left ventricular disease. The aim of this study was to assess the incidence of PH among patients diagnosed with hypertrophic cardiomyopath (HCM) and to evaluate its prognostic significance.</div></div><div><h3>Methods</h3><div>The study cohort consisted of 2781 patients with HCM. Among them, 226 patients had PH (8.1%), and 2555 patients did not have PH (91.8%). The fourteen demographic and clinical variables were matched between the two groups using a 1:3 propensity score matching (PSM) method. Kaplan–Meier survival curves and Cox proportional hazard regression models were used to evaluate the correlation between PH and mortality. Moreover, a competing risk regression analysis was conducted to assess the competing risk.</div></div><div><h3>Results</h3><div>Before matching, there were 519 (18.7 %) patients with all-cause mortality, including 292 (10.5 %) patients who experienced cardiovascular mortality and 128 (4.6 %) patients who experienced SCD. There was a significant difference in the Kaplan–Meier survival curves for all-cause mortality (log-rank <em>P</em> &lt; 0.0001), cardiovascular mortality (log-rank <em>P</em> &lt; 0.0001) and SCD (log-rank <em>P</em> = 0.0005). After matching, there were also significant differences in cardiovascular mortality (log-rank <em>P</em> = 0.011) and SCD (log-rank <em>P</em> = 0.042), but only a similar trend was observed for all-cause mortality (log-rank <em>P</em> = 0.052). Cox regression analyses suggested that PH was an independent risk predictor for cardiovascular mortality [HR: 1.666; 95 % CI: 1.145–2.424; <em>P</em> = 0.008].</div></div><div><h3>Conclusion</h3><div>HCM patients with PH characterized by increased cardiovascular mortality and SCD, as well as a similar trend in all-cause mortality. Moreover, PH is an independent risk factor for cardiovascular mortality.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101605"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in the prognostic utility of inflammatory and thrombotic cardiovascular risk markers in patients with chest pain of suspected coronary origin","authors":"Dennis Winston T. Nilsen ,&nbsp;Reidun Aarsetoey ,&nbsp;Volker Poenitz ,&nbsp;Thor Ueland ,&nbsp;Pål Aukrust ,&nbsp;Annika Elisabet Michelsen ,&nbsp;Trygve Brugger-Andersen ,&nbsp;Harry Staines ,&nbsp;Heidi Grundt","doi":"10.1016/j.ijcha.2025.101600","DOIUrl":"10.1016/j.ijcha.2025.101600","url":null,"abstract":"<div><h3>Background</h3><div>α1-antichymotrypsin (SERPINA3), high sensitivity C-reactive protein (hsCRP) and pentraxin 3 (PTX3) are acute phase proteins triggered by inflammation, whereas D-dimer, fibrin monomer and α2-antiplasmin are thrombo-fibrinolytic markers. Sex differences in relation to cardiovascular disease were investigated.</div></div><div><h3>Methods</h3><div>A total of 871 consecutive patients (61.0 % males; females: 77.3 years, males 69.1 years) were included. Of these, 380 were diagnosed with an acute myocardial infarction (MI). Stepwise Cox regression models, applying normalized continuous log_e/SD values, were fitted for the biomarkers with all-cause mortality, MI and stroke, respectively, and a composite endpoint within 7 years as the dependent variables.</div></div><div><h3>Results</h3><div>Except for α2-antiplasmin, all biomarkers were significantly associated with all-cause mortality and the combined endpoint in the univariate analysis. None of the inflammatory biomarkers predicted all-cause mortality in females after multivariable adjustment but were significant predictors in males (SERPINA3: HR 1.34 (95 %CI 1.16–1.56), p &lt; 0.0001. hsCRP: HR 1.19 (95 %CI 1.02–1.38), p = 0.027. PTX3: HR 1.22 [95 %CI 1.04–1.44], p = 0.018. The p-value for interaction suggests a sex difference in the prognostic weighting of SERPINA3 (p = 0.015). None of the thrombo-fibrinolytic biomarkers predicted all-cause mortality in males after adjustment, but D-dimer and fibrin monomer were significant predictors of all-cause mortality in females (HR 1.51 [1.29–1.78], p &lt; 0.0001, and HR 1.28 [1.08–1.53] p = 0.005, respectively). A trend towards interaction for D-dimer (p = 0.07) may suggest a sex difference in its prognostic weighting.</div></div><div><h3>Conclusion</h3><div>SERPINA3, hsCRP and PTX3 predicted long-term all-cause mortality in males but not in females. The opposite relationship was observed for D-dimer and fibrin monomer.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101600"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TAVI vs SAVR: The timeless showdown in aortic valve replacement","authors":"Massimo Baudo","doi":"10.1016/j.ijcha.2025.101608","DOIUrl":"10.1016/j.ijcha.2025.101608","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101608"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of novel ferroptosis-related biomarkers associated with the oxidative stress pathways in ischemic cardiomyopathy","authors":"Huilin Liu ,&nbsp;Yuan Xu ,&nbsp;Yuanmei Liu ,&nbsp;XueJun Han ,&nbsp;Liping Zhao ,&nbsp;Yixuan Liu ,&nbsp;Fuchun Zhang ,&nbsp;Yicheng Fu","doi":"10.1016/j.ijcha.2024.101584","DOIUrl":"10.1016/j.ijcha.2024.101584","url":null,"abstract":"<div><h3>Background</h3><div>Ferroptosis is a cell death process that depends on iron and reactive oxygen species. It significantly contributes to cardiovascular diseases. However, its exact role in ischemic cardiomyopathy (ICM) is still unclear.</div></div><div><h3>Methods</h3><div>Using bioinformatics methods, we identified new molecular targets associated with ferroptosis in ICM and conducted various analyses—including correlation analysis, pathway enrichment analysis, protein interaction network construction, and analysis of transcription factor and drug interactions, to reveal the potential mechanisms behind these genes.</div></div><div><h3>Results</h3><div>We evaluated two independent training sets of ICM, GSE57338 and GSE5406, comprising 203 ICM samples, and validation sets GSE76701 to examine differentially expressed genes (<em>DEGs</em>) related to ferroptosis. After extracting the intersection of the gene sets and ferroptosis-related genes, 53 <em>DEGs</em> were identified. Enrichment analyses showed that the alterations in ferroptosis-related <em>DEGs</em> were mainly enriched in oxidative stress response, and immune-related pathways. Furthermore, 11 hub genes were identified using protein–protein interaction network analysis. The key interactions between 11 hub genes were more pronounced in protein localization during ICM development. In addition, we construct a hub gene and transcription factor interaction network and a small molecule drug-gene interaction network. We found that among these hub genes, the N-acetylneuraminate outer membrane channel(<em>NANC)</em> gene is positively correlated with most of the small-molecule drugs used to treat ICM, and its high expression might increase resistance.</div></div><div><h3>Conclusions</h3><div>Ferroptosis exists in ICM and and is associated with oxidative stress. This association suggests that ferroptosis may facilitate the progression of ICM.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101584"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional myocardial assessment in cine cardiac computerized tomographic angiography using echocardiographic feature-tracking software in patients with and without significant coronary disease","authors":"Adi Hertz ,&nbsp;Michael Jerdev ,&nbsp;Liza Grosman-Rimon ,&nbsp;Itiel Ben-Zakai ,&nbsp;Jordan Rimon ,&nbsp;Offer Amir ,&nbsp;Gabby Elbaz Greener ,&nbsp;Shemy Carasso","doi":"10.1016/j.ijcha.2024.101586","DOIUrl":"10.1016/j.ijcha.2024.101586","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac computerized tomographic angiography (CCTA) is perceived as a non-invasive tool for assessment of coronary vessel anatomy. Feature tracking echocardiography has recently emerged as a tool for assessment of regional and global left ventricular function. We aimed to explore the applicability of echocardiographic strain on CCTA cine clips and assess whether global and regional strain parameters are associated with the extent of coronary stenosis.</div></div><div><h3>Methods</h3><div>CCTA studies of 61 consecutive patients were reconstructed to yield cine images in classic echocardiographic long and short views. Siemens Velocity Vector Imaging (VVI) software was applied to generate strain and displacement results. Volumetric and mechanics parameters were compared among patients with no or non-significant coronary artery disease (CAD) and patients with significant CAD. Finally, a comparison of the degree of coronary stenosis to regional segmental strain was performed.</div></div><div><h3>Results</h3><div>Myocardial mechanics parameters could be generated in 60 cases. Ejection fraction (EF) and left ventricular end diastolic volume (LVEDV) were within the normal range in both groups. VVI values were lower in the CAD group (VVI LVEF 59 ± 6 vs. 50 ± 11, p = 0.0002). Global longitudinal and global circumferential strain both were significantly lower in this group. Regional segmental strain was lower in segments affected by coronary stenosis in comparison to unaffected segments.</div></div><div><h3>Conclusion</h3><div>While CT segmentation derived LVEF did not differ among groups, patients with significant coronary stenosis had reduced longitudinal and circumferential contraction. This suggests that application of VVI to CCTA cine clips tracking may help to differentiate significant and non-significant coronary stenosis, adding functional value to anatomic findings in CCTA.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101586"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fully automated coronary artery calcium score and risk categorization from chest CT using deep learning and multiorgan segmentation: A validation study from National Lung Screening Trial (NLST)","authors":"Sudhir Rathore ,&nbsp;Ashish Gautam ,&nbsp;Prashant Raghav ,&nbsp;Vijay Subramaniam ,&nbsp;Vikash Gupta ,&nbsp;Maanya Rathore ,&nbsp;Ananmay Rathore ,&nbsp;Samir Rathore ,&nbsp;Srikanth Iyengar","doi":"10.1016/j.ijcha.2024.101593","DOIUrl":"10.1016/j.ijcha.2024.101593","url":null,"abstract":"<div><h3>Background</h3><div>The National Lung Screening Trial (NLST) has shown that screening with low dose CT in high-risk population was associated with reduction in lung cancer mortality. These patients are also at high risk of coronary artery disease, and we used deep learning model to automatically detect, quantify and perform risk categorisation of coronary artery calcification score (CACS) from non-ECG gated Chest CT scans.</div></div><div><h3>Materials and methods</h3><div>Automated calcium quantification was performed using a neural network based on Mask regions with convolutional neural networks (R-CNN) for multiorgan segmentation. Manual evaluation of calcium was carried out using proprietary software. This study used 80 patients to train the segmentation model and randomly selected 1442 patients were used for the validation of the algorithm. We compared the model generated results with Ground Truth.</div></div><div><h3>Results</h3><div>Automatic cardiac and aortic segmentation model worked well (Mean Dice score: 0.91). Cohen’s kappa coefficient between the reference actual and the interclass computed predictive categories on the test set is 0.72 (95 % CI: 0.61–0.83). Our method correctly classifies the risk group in 78.8 % of the cases and classifies the subjects in the same group. F-score is measured as 0.78; 0.71; 0.81; 0.82; 0.92 in calcium score categories 0(CS:0), I (1–99), II (100–400), III (400–1000), IV (&gt;1000), respectively. 79 % of the predictive scores lie in the same categories, 20 % of the predictive scores are one category up or down, and only 1.2 % patients were more than one category off. For the presence/absence of coronary artery calcifications, our deep learning model achieved a sensitivity of 90 % and a specificity of 94 %.</div></div><div><h3>Conclusion</h3><div>Fully automated model shows good correlation compared with reference standards. Automating the process could improve diagnostic ability, risk categorization, facilitate primary prevention intervention, improve morbidity and mortality, and decrease healthcare costs.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101593"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}