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心脏CT扫描中基于人工智能的左心房容积测量可改善CHARGE-AF评分,且在预测无症状个体房颤方面优于NT-脑钠肽:动脉粥样硬化多民族研究

AI-enabled Left Atrial Volumetry in Cardiac CT Scans Improves CHARGE-AF and Outperforms NT-ProBNP for Prediction of Atrial Fibrillation in Asymptomatic Individuals: Multi-Ethnic Study of Atherosclerosis.

作者信息

Naghavi Morteza, Yankelevitz David, Reeves Anthony P, Budoff Matthew J, Li Dong, Atlas Kyle C, Zhang Chenyu, Atlas Thomas L, Lirette Seth, Wasserthal Jakob, Henschke Claudia, Defilippi Christopher, Heckbert Susan R, Greenland Philip

机构信息

HeartLung.AI, 2450 Holcombe, Houston, TX, 77021.

Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029.

出版信息

medRxiv. 2024 Jan 24:2024.01.22.24301384. doi: 10.1101/2024.01.22.24301384.


DOI:10.1101/2024.01.22.24301384
PMID:38343816
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10854349/
Abstract

BACKGROUND: Coronary artery calcium (CAC) scans contain actionable information beyond CAC scores that is not currently reported. METHODS: We have applied artificial intelligence-enabled automated cardiac chambers volumetry to CAC scans (AI-CAC), taking on average 21 seconds per CAC scan, to 5535 asymptomatic individuals (52.2% women, ages 45-84) that were previously obtained for CAC scoring in the baseline examination (2000-2002) of the Multi-Ethnic Study of Atherosclerosis (MESA). We used the 5-year outcomes data for incident atrial fibrillation (AF) and compared the time-dependent AUC of AI-CAC LA volume with known predictors of AF, the CHARGE-AF Risk Score and NT-proBNP (BNP). The mean follow-up time to an AF event was 2.9±1.4 years. RESULTS: At 1,2,3,4, and 5 years follow-up 36, 77, 123, 182, and 236 cases of AF were identified, respectively. The AUC for AI-CAC LA volume was significantly higher than CHARGE-AF or BNP at year 1 (0.836, 0.742, 0.742), year 2 (0.842, 0.807,0.772), and year 3 (0.811, 0.785, 0.745) (p<0.02), but similar for year 4 (0.785, 0.769, 0.725) and year 5 (0.781, 0.767, 0.734) respectively (p>0.05). AI-CAC LA volume significantly improved the continuous Net Reclassification Index for prediction of AF over years 1-5 when added to CAC score (0.74, 0.49, 0.53, 0.39, 0.44), CHARGE-AF Risk Score (0.60, 0.28, 0.32, 0.19, 0.24), and BNP (0.68, 0.44, 0.42, 0.30, 0.37) respectively (p<0.01). CONCLUSION: AI-CAC LA volume enabled prediction of AF as early as one year and significantly improved on risk classification of CHARGE-AF Risk Score and BNP.

摘要

背景:冠状动脉钙化(CAC)扫描包含目前未报告的超出CAC评分的可操作信息。 方法:我们将基于人工智能的自动心腔容积测量技术应用于CAC扫描(AI-CAC),每次CAC扫描平均耗时21秒,对5535名无症状个体(52.2%为女性,年龄45 - 84岁)进行了检测,这些个体在动脉粥样硬化多族裔研究(MESA)的基线检查(2000 - 2002年)中曾进行过CAC评分。我们使用了房颤(AF)发病的5年结局数据,并将AI-CAC左心房容积的时间依赖性曲线下面积(AUC)与AF的已知预测指标——CHARGE-AF风险评分和N末端B型利钠肽原(NT-proBNP)进行了比较。AF事件的平均随访时间为2.9±1.4年。 结果:在1年、2年、3年、4年和5年的随访中,分别确诊了36例、77例、123例、182例和236例AF。在第1年(0.836、0.742、0.742)、第2年(0.842、0.807、0.772)和第3年(0.811、0.785、0.745)时,AI-CAC左心房容积的AUC显著高于CHARGE-AF或BNP(p<0.02),但在第4年(0.785、0.769、0.725)和第5年(0.781、0.767、0.734)时分别相似(p>0.05)。当将AI-CAC左心房容积添加到CAC评分(0.74、0.49、0.53、0.39、0.44)、CHARGE-AF风险评分(0.60、0.28、0.32、0.19、0.24)和BNP(0.68、0.44、0.42、0.30、0.37)中时,AI-CAC左心房容积在1 - 5年期间显著改善了AF预测的连续净重新分类指数(p<0.01)。 结论:AI-CAC左心房容积能够早在1年内预测AF,并显著改善CHARGE-AF风险评分和BNP的风险分类。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80db/10854349/86361d68e400/nihpp-2024.01.22.24301384v1-f0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80db/10854349/5e695b1a47f0/nihpp-2024.01.22.24301384v1-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80db/10854349/c5270ecca36a/nihpp-2024.01.22.24301384v1-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80db/10854349/86361d68e400/nihpp-2024.01.22.24301384v1-f0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80db/10854349/5e695b1a47f0/nihpp-2024.01.22.24301384v1-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80db/10854349/c5270ecca36a/nihpp-2024.01.22.24301384v1-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80db/10854349/86361d68e400/nihpp-2024.01.22.24301384v1-f0007.jpg

相似文献

[1]
AI-enabled Left Atrial Volumetry in Cardiac CT Scans Improves CHARGE-AF and Outperforms NT-ProBNP for Prediction of Atrial Fibrillation in Asymptomatic Individuals: Multi-Ethnic Study of Atherosclerosis.

medRxiv. 2024-1-24

[2]
AI-enabled left atrial volumetry in coronary artery calcium scans (AI-CAC) predicts atrial fibrillation as early as one year, improves CHARGE-AF, and outperforms NT-proBNP: The multi-ethnic study of atherosclerosis.

J Cardiovasc Comput Tomogr. 2024

[3]
AI-Enabled CT Cardiac Chamber Volumetry Predicts Atrial Fibrillation and Stroke Comparable to MRI.

JACC Adv. 2024-11-15

[4]
AI-enabled cardiac chambers volumetry in coronary artery calcium scans (AI-CAC) predicts heart failure and outperforms NT-proBNP: The multi-ethnic study of Atherosclerosis.

J Cardiovasc Comput Tomogr. 2024

[5]
AI-enabled Cardiac Chambers Volumetry and Calcified Plaque Characterization in Coronary Artery Calcium (CAC) Scans (AI-CAC) Significantly Improves on Agatston CAC Score for Predicting All Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis.

Res Sq. 2024-6-20

[6]
Artificial intelligence applied to coronary artery calcium scans (AI-CAC) significantly improves cardiovascular events prediction.

NPJ Digit Med. 2024-11-5

[7]
AI-enabled opportunistic measurement of liver steatosis in coronary artery calcium scans predicts cardiovascular events and all-cause mortality: an AI-CVD study within the Multi-Ethnic Study of Atherosclerosis (MESA).

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[8]
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[9]
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[10]
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