85 research outputs found

    A token-mixer architecture for CAD-RADS classification of coronary stenosis on multiplanar reconstruction CT images

    Get PDF
    Background and objective: In patients with suspected Coronary Artery Disease (CAD), the severity of stenosis needs to be assessed for precise clinical management. An automatic deep learning-based algorithm to classify coronary stenosis lesions according to the Coronary Artery Disease Reporting and Data System (CAD-RADS) in multiplanar reconstruction images acquired with Coronary Computed Tomography Angiography (CCTA) is proposed. Methods: In this retrospective study, 288 patients with suspected CAD who underwent CCTA scans were included. To model long-range semantic information, which is needed to identify and classify stenosis with challenging appearance, we adopted a token-mixer architecture (ConvMixer), which can learn structural relationship over the whole coronary artery. ConvMixer consists of a patch embedding layer followed by repeated convolutional blocks to enable the algorithm to learn long-range dependences between pixels. To visually assess ConvMixer performance, Gradient-Weighted Class Activation Mapping (Grad-CAM) analysis was used. Results: Experimental results using 5-fold cross-validation showed that our ConvMixer can classify significant coronary artery stenosis (i.e., stenosis with luminal narrowing ≥50%) with accuracy and sensitivity of 87% and 90%, respectively. For CAD-RADS 0 vs. 1–2 vs. 3–4 vs. 5 classification, ConvMixer achieved accuracy and sensitivity of 72% and 75%, respectively. Additional experiments showed that ConvMixer achieved a better trade-off between performance and complexity compared to pyramid-shaped convolutional neural networks. Conclusions: Our algorithm might provide clinicians with decision support, potentially reducing the interobserver variability for coronary artery stenosis evaluation

    Arterial Stiffness: Effects of Anticancer Drugs Used for Breast Cancer Women

    Get PDF
    Purpose: It is well known that anticancer drugs used for treating breast cancer can cause cardiac toxicity, and less is known about vascular toxicity. The aim of this study was to assess subclinical vascular effects of anthracyclines and trastuzumab (TRZ) in women treated for breast cancer. Methods: We enrolled 133 female patients with breast cancer undergoing adjuvant treatment with anthracycline-containing chemotherapy (CT) followed by taxane (paclitaxel/docetaxel) + TRZ. Patients underwent a standard echocardiography including measurement of left ventricular ejection fraction and global longitudinal strain at baseline and at follow-up. Vascular toxicity was evaluated by measuring brachial blood pressure (BP) and arterial stiffness indices (pulse wave velocity and Beta stiffness index) at T0 (baseline), T1 (3 months), T2 (6 months), and T3 (12 months). Results: Arterial stiffness indices were significantly increased at T1 in patients treated with anthracycline-containing CT (PWV 5.5 m/s IQR 5.15–6.4 at T0 vs. PWV 6.7 m/s IQR 5.6–7.2 at T1, p < 0.05; Beta index PWV 6.7 IQR 5.25–6.65 at T0, PWV 8.35 IQR 6.5–10.15 at T1, p < 0.05) but not at T2 and T3, when treatment with anthracyclines was stopped and patients were under treatment with taxane and TRZ. Blood pressure values did not significantly change during follow-up. Conclusion: Changes in arterial stiffness parameters occur early after starting treatment with anthracyclines, and they seem to be reversible if anthracycline treatment is stopped. These changes are not influenced by blood pressure values modifications. Therefore, in breast cancer women, anthracyclines seem to cause early reversible subclinical vascular injury

    2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).

    Get PDF
    European Society of CardiologyThis is the author accepted manuscript. The final version is available from Oxford University Press via http://dx.doi.org/10.1093/eurheartj/ehw10

    2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC

    Get PDF
    2016 ESC on Acute and Chronic H

    Multimodality imaging in chronic heart failure

    No full text
    The prevalence of heart failure (HF) is approximately 1–2% of the adult population in developed countries, rising to ≥ 10% among people over 70. The common symptoms of HF include shortness of breath, ankle swelling and fatigue, determined by a reduced cardiac output. Multimodality imaging is crucial to define HF etiology, determine prognosis and guiding tailored treatments. Echocardiography is the most widely used imaging modality and maintains a pivotal role in the initial diagnostic work-up and in the follow-up of HF patients. Cardiac magnetic resonance (CMR) may support the morpho-functional assessment provided by echocardiography when the acoustic window is limited or a gold standard evaluation is required. Furthermore, CMR is frequently used due to the unmatched capability to characterize myocardial structure. Coronary computed tomography angiography has become the non-invasive imaging of choice to diagnose or rule-out coronary artery disease, acquiring remarkable importance in the management of HF patients. Moreover, emerging capabilities of CT-based tissue characterization may be useful, especially when CMR is contraindicated. Finally, chest CT may contribute to precisely define the framework of HF patients, revealing new insight about cardiopulmonary pathophysiological interactions with potential high prognostic value

    Role of two-dimensional speckle-tracking echocardiography strain in the assessment of right ventricular systolic function and comparison with conventional parameters

    No full text
    Despite the already well-known role the right side of the heart plays in many diseases, right ventricular (RV) function has only recently been carefully considered. Echocardiography is the first-line diagnostic technique for the assessment of the right ventricle and right atrium, whereas cardiac magnetic resonance is considered the gold standard but is limited by cost and availability. According to the current guidelines, systolic RV function should be assessed by several conventional measurements, but the efficacy of these parameters as diagnostic and prognostic tools has been questioned by many authors. The development in recent years of myocardial deformation imaging techniques and their application to the right heart chambers has allowed deeper evaluation of the importance of RV function in the pathophysiology of a large number of cardiovascular conditions, but the real value of this new tool has not been completely clarified. The aim of this review is to provide a wide and careful analysis of findings available in the literature about the assessment of RV systolic function by strain measurements, comparing them with conventional parameters and evaluating their role in several clinical settings
    corecore