Zhang Yuxuan, Wang Moyang, Zhang Erli, Wu Yongjian
Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.
Center for Structural Heart Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.
Rev Cardiovasc Med. 2024 Jan 17;25(1):31. doi: 10.31083/j.rcm2501031. eCollection 2024 Jan.
The integration of artificial intelligence (AI) into clinical management of aortic stenosis (AS) has redefined our approach to the assessment and management of this heterogenous valvular heart disease (VHD). While the large-scale early detection of valvular conditions is limited by socioeconomic constraints, AI offers a cost-effective alternative solution for screening by utilizing conventional tools, including electrocardiograms and community-level auscultations, thereby facilitating early detection, prevention, and treatment of AS. Furthermore, AI sheds light on the varied nature of AS, once considered a uniform condition, allowing for more nuanced, data-driven risk assessments and treatment plans. This presents an opportunity to re-evaluate the complexity of AS and to refine treatment using data-driven risk stratification beyond traditional guidelines. AI can be used to support treatment decisions including device selection, procedural techniques, and follow-up surveillance of transcatheter aortic valve replacement (TAVR) in a reproducible manner. While recognizing notable AI achievements, it is important to remember that AI applications in AS still require collaboration with human expertise due to potential limitations such as its susceptibility to bias, and the critical nature of healthcare. This synergy underpins our optimistic view of AI's promising role in the AS clinical pathway.
将人工智能(AI)整合到主动脉瓣狭窄(AS)的临床管理中,重新定义了我们对这种异质性瓣膜性心脏病(VHD)的评估和管理方法。虽然瓣膜疾病的大规模早期检测受到社会经济限制,但人工智能通过利用包括心电图和社区层面听诊在内的传统工具,为筛查提供了一种经济高效的替代解决方案,从而促进了AS的早期检测、预防和治疗。此外,人工智能揭示了曾被认为是单一病症的AS的多样性质,使得能够进行更细致入微、基于数据的风险评估和治疗计划。这为重新评估AS的复杂性以及使用超越传统指南的数据驱动风险分层来优化治疗提供了契机。人工智能可用于以可重复的方式支持治疗决策,包括器械选择、手术技术以及经导管主动脉瓣置换术(TAVR)的随访监测。在认识到人工智能取得的显著成就的同时,重要的是要记住,由于存在诸如易受偏差影响以及医疗保健的关键性质等潜在限制,人工智能在AS中的应用仍需要与人类专业知识协作。这种协同作用支撑着我们对人工智能在AS临床路径中发挥的有前景作用的乐观看法。