TY - JOUR
T1 - Precision Phenotyping in Heart Failure and Pattern Clustering of Ultrasound Data for the Assessment of Diastolic Dysfunction
AU - Omar, Alaa Mabrouk Salem
AU - Narula, Sukrit
AU - Abdel Rahman, Mohamed Ahmed
AU - Pedrizzetti, Gianni
AU - Raslan, Hala
AU - Rifaie, Osama
AU - Narula, Jagat
AU - Sengupta, Partho P.
N1 - Publisher Copyright:
© 2017 American College of Cardiology Foundation
PY - 2017/11
Y1 - 2017/11
N2 - Objectives The aim of this study was to investigate whether cluster analysis of left atrial and left ventricular (LV) mechanical deformation parameters provide sufficient information for Doppler-independent assessment of LV diastolic function. Background Medical imaging produces substantial phenotyping data, and superior computational analyses could allow automated classification of repetitive patterns into patient groups with similar behavior. Methods The authors performed a cluster analysis and developed a model of LV diastolic function from an initial exploratory cohort of 130 patients that was subsequently tested in a prospective cohort of 44 patients undergoing cardiac catheterization. Patients in both study groups had standard echocardiographic examination with Doppler-derived assessment of diastolic function. Both the left ventricle and the left atrium were tracked simultaneously using speckle-tracking echocardiography (STE) for measuring simultaneous changes in left atrial and ventricular volumes, volume rates, longitudinal strains, and strain rates. Patients in the validation group also underwent invasive measurements of pulmonary capillary wedge pressure and LV end diastolic pressure immediately after echocardiography. The similarity between STE and conventional 2-dimensional and Doppler methods of diastolic function was investigated in both the exploratory and validation cohorts. Results STE demonstrated strong correlations with the conventional indices and independently clustered the patients into 3 groups with conventional measurements verifying increasing severity of diastolic dysfunction and LV filling pressures. A multivariable linear regression model also allowed estimation of E/e′ and pulmonary capillary wedge pressure by STE in the validation cohort. Conclusions Tracking deformation of the left-sided cardiac chambers from routine cardiac ultrasound images provides accurate information for Doppler-independent phenotypic characterization of LV diastolic function and noninvasive assessment of LV filling pressures.
AB - Objectives The aim of this study was to investigate whether cluster analysis of left atrial and left ventricular (LV) mechanical deformation parameters provide sufficient information for Doppler-independent assessment of LV diastolic function. Background Medical imaging produces substantial phenotyping data, and superior computational analyses could allow automated classification of repetitive patterns into patient groups with similar behavior. Methods The authors performed a cluster analysis and developed a model of LV diastolic function from an initial exploratory cohort of 130 patients that was subsequently tested in a prospective cohort of 44 patients undergoing cardiac catheterization. Patients in both study groups had standard echocardiographic examination with Doppler-derived assessment of diastolic function. Both the left ventricle and the left atrium were tracked simultaneously using speckle-tracking echocardiography (STE) for measuring simultaneous changes in left atrial and ventricular volumes, volume rates, longitudinal strains, and strain rates. Patients in the validation group also underwent invasive measurements of pulmonary capillary wedge pressure and LV end diastolic pressure immediately after echocardiography. The similarity between STE and conventional 2-dimensional and Doppler methods of diastolic function was investigated in both the exploratory and validation cohorts. Results STE demonstrated strong correlations with the conventional indices and independently clustered the patients into 3 groups with conventional measurements verifying increasing severity of diastolic dysfunction and LV filling pressures. A multivariable linear regression model also allowed estimation of E/e′ and pulmonary capillary wedge pressure by STE in the validation cohort. Conclusions Tracking deformation of the left-sided cardiac chambers from routine cardiac ultrasound images provides accurate information for Doppler-independent phenotypic characterization of LV diastolic function and noninvasive assessment of LV filling pressures.
KW - big-data analytics
KW - diastolic dysfunction
KW - left ventricular filling pressures
KW - speckle-tracking echocardiography
UR - http://www.scopus.com/inward/record.url?scp=85009809469&partnerID=8YFLogxK
U2 - 10.1016/j.jcmg.2016.10.012
DO - 10.1016/j.jcmg.2016.10.012
M3 - Article
C2 - 28109936
AN - SCOPUS:85009809469
SN - 1936-878X
VL - 10
SP - 1291
EP - 1303
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 11
ER -