Cohen-Shelly, Michal

Abstract Background Mitral regurgitation (MR) and tricuspid regurgitation (TR) are prevalent valvular heart diseases associated with significant morbidity and mortality. Traditional echocardiography faces limitations in availability, cost, consistency, and reliability, leading to misdiagnosis and undertreatment. The application of artificial intelligence (AI) to echocardiographic scans has the potential to address these challenges. Methods This study evaluates the performance of an AI algorithm on an external population. The algorithm utilizes deep learning networks to analyze echocardiographic exams for diagnosing atrioventricular valve disorders. We tested the algorithm on transthoracic echocardiography data collected from a single center between 2013 and 2023. The model's performance was compared to ground truth values using two classification schemes: distinguishing between normal-mild and moderate-severe regurgitation, and categorizing results into four groups: normal, mild, moderate, and severe. Results The MR cohort included 280 patients, while the TR cohort comprised 298 patients. The model demonstrated a robust ability to identify clinically significant (moderate and above) atrioventricular valve regurgitation. The MR model achieved an area under the curve (AUC) of 0.98 (95% CI: 0.97–0.99), with 91% accuracy, 95% sensitivity, and 89% specificity. In comparison, the TR model exhibited an AUC of 0.96 (95% CI: 0.94–0.98), with 84% accuracy, 91% sensitivity, and 80% specificity. Conclusion The model demonstrated high diagnostic accuracy and reliability in assessing atrioventricular valve regurgitation severity, highlighting its potential as a valuable clinical tool. The findings underscore the role of AI in complementing expert evaluations and improving access to effective diagnostics, with future applications potentially including point-of-care diagnosis and monitoring of disease progression.

Abstract Coronary artery disease (CAD) is a leading health challenge worldwide. Exercise stress testing is a foundational non-invasive diagnostic tool. Nonetheless, its variable accuracy prompts the exploration of more reliable methods. Recent advancements in machine learning (ML), including deep learning and natural language processing, have shown potential in refining the interpretation of stress testing data. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review of ML applications in stress electrocardiogram (ECG) and stress echocardiography for CAD prognosis. Medical Literature Analysis and Retrieval System Online, Web of Science, and the Cochrane Library were used as databases. We analysed the ML models, outcomes, and performance metrics. Overall, seven relevant studies were identified. Machine-learning applications in stress ECGs resulted in sensitivity and specificity improvements. Some models achieved rates of above 96% in both metrics and reduced false positives by up to 21%. In stress echocardiography, ML models demonstrated an increase in diagnostic precision. Some models achieved specificity and sensitivity rates of up to 92.7 and 84.4%, respectively. Natural language processing applications enabled the categorization of stress echocardiography reports, with accuracy rates nearing 98%. Limitations include a small, retrospective study pool and the exclusion of nuclear stress testing, due to its well-documented status. This review indicates the potential of artificial intelligence applications in refining CAD stress testing assessment. Further development for real-world use is warranted.