在心脏手术后监测全身心室动脉合,使用连续的 transoesophageal 心声学和深度学习
Jinyang Yu1,2,3, Tomas Dybos Tannvik4, Anders Austlid Taskén5
1Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway. jinyang_yu@hotmail.com.
Journal of clinical monitoring and computing
|July 17, 2025
概括
一个新的工具,autoMAPSE,使用心声回声和深度学习来监测手术后的心脏功能. 它准确地反映了心室动脉合,并预测了像ProBNP和TnT这样的心脏生物标志物.
科学领域:
- 心血管生理学心血管生理学
- 医疗技术 医疗技术 医学技术
- 人工智能在医学中的应用
背景情况:
- 心室动脉合对心血管和左心室功能至关重要.
- 这种合的恶化可能会产生严重的后果.
- 需要持续监测左心室功能,特别是心脏手术后.
研究的目的:
- 开发和验证autoMAPSE,这是一种新的工具,可以使用跨食道心声学和深度学习自动测量额头环状平面缩外流 (MAPSE).
- 评估autoMAPSE是否可以监测系统性心室动脉合并检测术后心脏生物标志物的变化.
- 为了评估自动MAPSE,心室动脉合指数和心脏生物标志物 (ProBNP,TnT) 在早期术后期之间的关系.
主要方法:
- 50名接受心脏手术的患者在术后被监测了120分钟.
- 每5分钟记录一次自动MAPSE测量和平均动脉压 (MAP).
- 用动脉弹性与末性弹性比率 (Ea/Ees) 来评估心室动脉合.
- 测量了手术后的N-终端亲B型尿素 (ProBNP) 和高灵敏度素-T (TnT) 的水平.
- 统计分析包括相关性和线性混合效应模型来评估关系.
主要成果:
- 自动MAPSE与Ea/Ees比率有显著的负相关性,表明它能够反映心室动脉合.
- 个体患者数据显示,自动MAPSE和MAP之间的关系具有显著的异质性,突出了个性化的合动态.
- 连续的自动MAPSE测量与术后的峰值ProBNP和Troponin-T水平有负相关性.
- 该工具在反映心室动脉合和预测心脏生物标志物水平方面表现出有效性.
结论:
- 自动MAPSE工具提供了心脏手术后的左心室功能和心室动脉合的持续,非侵入性监测.
- 在随后的24小时内,早期术后的自动MAPSE测量与关键心脏生物标志物 (ProBNP,TnT) 相相关.
- 自动MAPSE显示承诺作为一个有价值的工具,用于实时评估和管理心血管功能在关键的术后期.
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