Dataset Information

Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study.

ABSTRACT:

Background

We sought to evaluate the association of metabolic syndrome (MetS) and computed tomography (CT)-derived cardiometabolic biomarkers (non-alcoholic fatty liver disease [NAFLD] and epicardial adipose tissue [EAT] measures) with long-term risk of major adverse cardiovascular events (MACE) in asymptomatic individuals.

Methods

This was a post-hoc analysis of the prospective EISNER (Early-Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) study of participants who underwent baseline coronary artery calcium (CAC) scoring CT and 14-year follow-up for MACE (myocardial infarction, late revascularization, or cardiac death). EAT volume (cm³) and attenuation (Hounsfield units [HU]) were quantified from CT using fully automated deep learning software (ResultsIn the final population of 2068 participants (59% males, 56?±?9 years), those with MetS (n?=?280;13.5%) had a greater prevalence of NAFLD (26.0% vs. 9.9%), higher EAT volume (114.1 cm³ vs. 73.7 cm³), and lower EAT attenuation (-76.9 HU vs. -73.4 HU; all p?ConclusionsMetS, NAFLD, and artificial intelligence-based EAT measures predict long-term MACE risk in asymptomatic individuals. Imaging biomarkers of cardiometabolic disease have the potential for integration into routine reporting of CAC scoring CT to enhance cardiovascular risk stratification. Trial registration NCT00927693.

SUBMITTER: Lin A

PROVIDER: S-EPMC7847161 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study.

Lin Andrew A Wong Nathan D ND Razipour Aryabod A McElhinney Priscilla A PA Commandeur Frederic F Cadet Sebastien J SJ Gransar Heidi H Chen Xi X Cantu Stephanie S Miller Robert J H RJH Nerlekar Nitesh N Wong Dennis T L DTL Slomka Piotr J PJ Rozanski Alan A Tamarappoo Balaji K BK Berman Daniel S DS Dey Damini D

Cardiovascular diabetology 20210129 1

<h4>Background</h4>We sought to evaluate the association of metabolic syndrome (MetS) and computed tomography (CT)-derived cardiometabolic biomarkers (non-alcoholic fatty liver disease [NAFLD] and epicardial adipose tissue [EAT] measures) with long-term risk of major adverse cardiovascular events (MACE) in asymptomatic individuals.<h4>Methods</h4>This was a post-hoc analysis of the prospective EISNER (Early-Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) study of p ...[more]

PMID: 33514365

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Project description:BackgroundCardiac arrest is a life-threatening cessation of activity in the heart. Early prediction of cardiac arrest is important, as it allows for the necessary measures to be taken to prevent or intervene during the onset. Artificial intelligence (AI) technologies and big data have been increasingly used to enhance the ability to predict and prepare for the patients at risk.ObjectiveThis study aims to explore the use of AI technology in predicting cardiac arrest as reported in the literature.MethodsA scoping review was conducted in line with the guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews. Scopus, ScienceDirect, Embase, the Institute of Electrical and Electronics Engineers, and Google Scholar were searched to identify relevant studies. Backward reference list checks of the included studies were also conducted. Study selection and data extraction were independently conducted by 2 reviewers. Data extracted from the included studies were synthesized narratively.ResultsOut of 697 citations retrieved, 41 studies were included in the review, and 6 were added after backward citation checking. The included studies reported the use of AI in the prediction of cardiac arrest. Of the 47 studies, we were able to classify the approaches taken by the studies into 3 different categories: 26 (55%) studies predicted cardiac arrest by analyzing specific parameters or variables of the patients, whereas 16 (34%) studies developed an AI-based warning system. The remaining 11% (5/47) of studies focused on distinguishing patients at high risk of cardiac arrest from patients who were not at risk. Two studies focused on the pediatric population, and the rest focused on adults (45/47, 96%). Most of the studies used data sets with a size of <10,000 samples (32/47, 68%). Machine learning models were the most prominent branch of AI used in the prediction of cardiac arrest in the studies (38/47, 81%), and the most used algorithm was the neural network (23/47, 49%). K-fold cross-validation was the most used algorithm evaluation tool reported in the studies (24/47, 51%).ConclusionsAI is extensively used to predict cardiac arrest in different patient settings. Technology is expected to play an integral role in improving cardiac medicine. There is a need for more reviews to learn the obstacles to the implementation of AI technologies in clinical settings. Moreover, research focusing on how to best provide clinicians with support to understand, adapt, and implement this technology in their practice is also necessary.

Project description:BackgroundIn-hospital cardiac arrest is a major burden in health care. Although several track-and-trigger systems are used to predict cardiac arrest, they often have unsatisfactory performances. We hypothesized that a deep-learning-based artificial intelligence algorithm (DLA) could effectively predict cardiac arrest using electrocardiography (ECG). We developed and validated a DLA for predicting cardiac arrest using ECG.MethodsWe conducted a retrospective study that included 47,505 ECGs of 25,672 adult patients admitted to two hospitals, who underwent at least one ECG from October 2016 to September 2019. The endpoint was occurrence of cardiac arrest within 24 h from ECG. Using subgroup analyses in patients who were initially classified as non-event, we confirmed the delayed occurrence of cardiac arrest and unexpected intensive care unit transfer over 14 days.ResultsWe used 32,294 ECGs of 10,461 patients and 4483 ECGs of 4483 patients from a hospital were used as development and internal validation data, respectively. Additionally, 10,728 ECGs of 10,728 patients from another hospital were used as external validation data, which confirmed the robustness of the developed DLA. During internal and external validation, the areas under the receiver operating characteristic curves of the DLA in predicting cardiac arrest within 24 h were 0.913 and 0.948, respectively. The high risk group of the DLA showed a significantly higher hazard for delayed cardiac arrest (5.74% vs. 0.33%, P < 0.001) and unexpected intensive care unit transfer (4.23% vs. 0.82%, P < 0.001). A sensitivity map of the DLA displayed the ECG regions used to predict cardiac arrest, with the DLA focused most on the QRS complex.ConclusionsOur DLA successfully predicted cardiac arrest using diverse formats of ECG. The results indicate that cardiac arrest could be screened and predicted not only with a conventional 12-lead ECG, but also with a single-lead ECG using a wearable device that employs our DLA.

Dataset Information

Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study.

Background

Methods

Publications

Metabolic syndrome, fatty liver, and artificial intelligence-based epicardial adipose tissue measures predict long-term risk of cardiac events: a prospective study.

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