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定义轻度大动脉狭窄的新值来自6万个个体的速度编码MRI

Shinwan Kany¹, Joel T Rämö², David Playford³

¹Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA; Department of Cardiology, University Heart and Vascular Center Hamburg-Eppendorf, Hamburg, Germany; Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.

Journal of the American College of Cardiology

|April 2, 2025

概括

通过对心脏MRI数据的深度学习,确定了轻度大动脉狭窄症 (AS) 的新定义. 这种轻度AS分类与心力衰竭,心房动和死亡率的风险增加有关.

科学领域:

心脏病学心脏病学
医疗成像医学成像
人工智能的人工智能

背景情况:

轻度大动脉狭窄 (AS) 与不良结果有关,但缺乏准确的定义.
目前对轻度AS的理解尚不完整,需要进一步的流行病学研究.

研究的目的:

检查大动脉 (AV) 功能的流行病学,特别关注在没有先前临床指示的情况下获得的测量.
根据人口层面的数据,建立定义轻度AS的新标准.

主要方法:

开发了一个深度学习模型来分析来自62,902名英国生物库参与者的速度编码心磁共振成像 (CMR) 的大动脉 (AV) 参数.
这些发现被外部验证,使用来自澳大利亚国家回声数据库 (NEDA) 的数据,其中包括365,870名个人.
在一个健康的子队列中,建立了AV功能的参考范围,以确定轻度AS的门.

主要成果:

提出了轻度AS的新定义:峰值速度>1.65m/s,平均梯度>4.9mm Hg,或AV面积<2.1cm2 (男性) 或<1.7cm2 (女性).
在英国生物库中,5.8%的参与者符合轻度AS标准,显示AV置换,心房动和心力衰竭的危险比率显著增加.
在NEDA队列中,使用这些标准识别出轻度AS的个体表现出所有原因死亡率的增加.

结论:

这项大规模研究定义了异常AV血液动力学的人口值,确定了轻度AS的新标准.
轻度AS的拟议定义与不良心血管结果有关,包括心力衰竭,心房动和死亡率的风险增加,在英国生物银行和NEDA队列中.

关键词:

大动脉狭窄症 (大动脉狭窄)大动脉门的大动脉门心脏磁共振成像 - 心脏磁共振成像心血管疾病心血管疾病深度学习是一种深度学习.

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