Self supervised convolutional kernel based handcrafted feature harmonization: Enhanced left ventricle hypertension disease phenotyping on echocardiography

Radiomics, a medical imaging technique, extracts quantitative handcrafted features from images to predict diseases. Harmonization in those features ensures consistent feature extraction across various imaging devices and protocols. Methods for harmonization include standardized imaging protocols, statistical adjustments, and evaluating feature robustness. Myocardial diseases such as Left Ventricular Hypertrophy (LVH) and Hypertensive Heart Disease (HHD) are diagnosed via echocardiography, but variable imaging settings pose challenges. Harmonization techniques are crucial for applying handcrafted features in disease diagnosis in such scenario. Self-supervised learning (SSL) enhances data understanding within limited datasets and adapts to diverse data settings. ConvNeXt-V2 integrates convolutional layers into SSL, displaying superior performance in various tasks. This study focuses on convolutional filters within SSL, using them as preprocessing to convert images into feature maps for handcrafted feature harmonization. Our proposed method excelled in harmonization evaluation and exhibited superior LVH classification performance compared to existing methods.Comment: 11 pages, 7 figure

Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Valvular Heart Disease

Background: There are limited data for non-vitamin K antagonist oral anticoagulants (NOACs) impact on outcomes for patients with atrial fibrillation (AF) and valvular heart diseases (VHDs). Methods: We identified patients with AF and associated Evaluated Heartvalves, Rheumatic or Artificial (EHRA) type 2 VHDs, and who had been naïve from the oral anticoagulants in the Korean National Health Insurance Service database between 2014 and 2016 (warfarin: n = 2671; NOAC: n = 3058). For analyzing the effect of NOAC on primary prevention, we excluded those with a previous history of ischemic stroke, intracranial hemorrhage (ICH), and gastrointestinal (GI) bleeding events. To balance covariates, we used the propensity score weighting method. Ischemic stroke, ICH, GI bleeding, major bleeding, all-cause death, and their composite outcome and fatal clinical events were evaluated. Results: During a follow-up with a mean duration of 1.4 years, NOACs were associated with lower risks of ischemic stroke (hazard ratio (HR): 0.71, 95% confidence interval (CI): 0.53–0.96), GI bleeding (HR: 0.50, 95% CI: 0.35–0.72), fatal ICH (HR: 0.28, 95% CI: 0.07–0.83), and major bleeding (HR: 0.61, 95% CI: 0.45–0.80) compared with warfarin. Overall, NOACs were associated with a lower risk of the composite outcome (HR: 0.68, 95% CI: 0.58–0.80). Conclusions: In this nationwide Asian AF population with EHRA type 2 VHDs, NOAC use was associated with lower risks of ischemic stroke, major bleeding, all-cause death, and the composite outcome compared to warfarin use

Prognostic value of routine blood tests along with clinical risk factors in predicting ischemic stroke in non-valvular atrial fibrillation: a prospective cohort study

Abstract Background In patients with atrial fibrillation (AF), most biomarkers are still of limited use due to cost-effectiveness and complexity in clinical practice. Hypotheses Biomarkers from routine blood tests improve the current risk stratification in AF patients. Methods This prospective study enrolled 600 patients diagnosed with non-valvular AF, of whom 537 were analyzed. Platelet count; platelet distribution width (PDW); red cell distribution width (RDW); and creatinine, D-dimer, and troponin I levels were measured at enrollment. Results During the mean follow-up period (2.2 ± 0.6years), 1.9% patients developed ischemic stroke. According to the optimal cutoff of each biomarker, the risk of ischemic stroke was higher in patients with RDW ≥ 13.5%, creatinine ≥ 1.11mg/dL, or PDW ≥ 13.2% (significant biomarkers; P value: < 0.01, 0.04, or 0.07, respectively). These 3 significant biomarkers had higher information gain than clinical risk factors in predicting ischemic stroke. The cumulative incidence of ischemic stroke was 1.2%, 1.1%, 8.4%, and 40.0% in patients with 0, 1, 2, and 3 significant biomarkers, respectively (P-for-trend < 0.001). Patients with  ≥ 2 significant biomarkers had a significantly higher risk of ischemic stroke than those with  < 2 significant biomarkers (adjusted hazard ratio 11.5, 95% confidence interval 3.3–40.2, P < 0.001). The predictability for ischemic stroke was significantly improved when  ≥ 2 significant biomarkers were added to the CHA2DS2–VASc score (area under the curve 0.790 vs. 0.620, P = 0.043). Conclusion Routine blood tests can provide better risk stratification of AF along with clinical risk factors

Hemo-metabolic impairment in patients with ST-segment elevation myocardial infarction: Data from the INTERSTELLAR registry

Background: Not only hemo-dynamic (HD) factors but also hemo-metabolic (HM) risk factors reflecting multi-organ injuries are considered as important prognostic factors in ST-segment elevation myocardial infarction (STEMI). However, studies regarding HM risk factors in STEMI patients are currently limited. Method: Under analysis were 1,524 patients with STEMI who underwent primary percutaneous coronary intervention in the INTERSTELLAR registry. Patients were divided into HM (≥ 2 risk factors) and non-HM impairment groups. The primary outcome was in-hospital all-cause mortality, and the secondary outcome was 1-year all-cause mortality. Results: Of 1,524 patients, 214 (14.0%) and 1,310 (86.0%) patients were in the HM and non-HM impairment groups, respectively. Patients with HM impairment had a higher incidence of in-hospital mortality than those without (24.3% vs. 2.7%, p &lt; 0.001). After adjusting for confounders, HM impairment was independently associated with in-hospital mortality (inverse probability of treatment weighting [IPTW]-adjusted odds ratio: 1.81, 95% confidence interval: 1.08–3.14). In the third door-to-balloon (DTB) time tertile (≥ 82 min), HM impairment was strongly associated with in-hospital mortality. In the first DTB time tertile ( &lt; 62 min), indicating relatively rapid revascularization, HM impairment was consistently associated with increased in-hospital mortality. Conclusions: Hemo-metabolic impairment is significantly associated with increased risk of in-hospital and 1-year mortality in patients with STEMI. It remains a significant prognostic factor, regardless of DTB time

Exploiting Synergies of Multiple Crossovers: Initial Studies

Genetic algorithms (GAs) are believed to exploit the synergy between different traversals of the solution space that are afforded by crossover and mutation operators. While dozens of different crossovers are known, comparatively little attention has been devoted to improving performance by using multiple crossover operators within a given GA implementation. Here, we examine various aspects of combining different crossovers; we demonstrate that mixtures of crossovers can outperform any single crossover, and that choosing appropriate mixing proportions is critical for good performance. We conjecture that good crossover mixtures are characterized by &quot;balance&quot; in the crossovers&apos; respective influences in the population, and explore three adaptive strategies for mixing crossovers. 1 Introduction The crossover and mutation operators of genetic algorithms (GAs) navigate the solution space in synergetic ways: crossover generates new solutions by combining traits of already-visited solutions, w..

Prediction of Heart Function and Volume Status in End-Stage Kidney Disease Patients through N-Terminal Pro-Brain Natriuretic Peptide

Background and Objectives: N-terminal pro-brain natriuretic peptide (NT-proBNP) is a biomarker used to predict heart failure and evaluate volume status in hemodialysis (HD) patients. However, it is difficult to determine the cutoff value for NT-proBNP in HD patients. In this study, we analyzed whether NT-proBNP helps predict heart function and volume status in HD patients. Materials and Methods: This prospective observational study enrolled 96 end-stage kidney disease patients with HD. All patients underwent echocardiography and bioimpedance spectroscopy (BIS) after an HD session. Overhydration (OH) was measured by BIS. Laboratory data were obtained preHD, while serum NT-proBNP was measured after HD. Interventions for blood pressure control and dry weight control were performed, and NT-proBNP was re-assessed after a month. Results: There was an inverse correlation between NT-proBNP and ejection fraction (EF) (β = −0.34, p = 0.001). OH (β = 0.331, p = 0.001) and diastolic dysfunction (β = 0.226, p = 0.027) were associated with elevated NT-proBNP. In a subgroup analysis of diastolic dysfunction grade, NT-proBNP increased according to dysfunction grade (normal, 4177 pg/mL [2637–10,391]; grade 1, 9736 pg/mL [5471–21,110]; and grades 2–3, 26,237 pg/mL [16,975–49,465]). NT-proBNP showed a tendency toward a decrease in the ‘reduced dry weight’ group and toward an increase in the ‘increased dry weight’ group compared to the control group (ΔNT-proBNP, −210 pg/mL [−12,899 to 3142], p = 0.104; 1575 pg/mL [−113 to 6439], p = 0.118). Conclusions: We confirmed that NT-proBNP is associated with volume status as well as heart function in HD patients