Skip to main content

Advertisement

Log in

Artificial Intelligence in Cardiovascular Medicine

  • State-of-the-Art Informatics (J Singh, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

The ripples of artificial intelligence are being felt in various sectors of human life. Machine learning, a subset of artificial intelligence, extracts information from large databases of information and is gaining traction in various fields of cardiology. In this review, we highlight noteworthy examples of machine learning utilization in echocardiography, nuclear cardiology, computed tomography, and magnetic resonance imaging over the past year.

Recent findings

In the past year, machine learning (ML) has expanded its boundaries in cardiology with several positive results. Some studies have integrated clinical and imaging information to further augment the accuracy of these ML algorithms. All the studies mentioned in this review have clearly demonstrated superior results of ML in relation to conventional approaches for identifying obstructions or predicting major adverse events in reference to conventional approaches.

Summary

As the influx of data arriving from gradually evolving technologies in health care and wearable devices continues to be more complex, ML may serve as the bridge to transcend the gap between health care and patients in the future. In order to facilitate a seamless transition between both, a few issues must be resolved for a successful implementation of ML in health care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart disease and stroke statistics-2018 update: a report from the American Heart Association. Circulation. 2018;137(12):e67–e492.

    Article  Google Scholar 

  2. Sengupta PP, Shrestha S. Machine learning for data-driven discovery: the rise and relevance. JACC Cardiovasc Imaging 2018.

  3. Koohy H. The rise and fall of machine learning methods in biomedical research. F1000Res. 2017;6:2012.

    Article  Google Scholar 

  4. Al’Aref SJ, Anchouche K, Singh G, Slomka PJ, Kolli KK, Kumar A, et al. Clinical applications of machine learning in cardiovascular disease and its relevance to cardiac imaging. Eur Heart J 2018.

  5. Shameer K, Johnson KW, Glicksberg BS, Dudley JT, Sengupta PP. Machine learning in cardiovascular medicine: are we there yet? Heart. 2018;104(14):1156–64.

    Article  Google Scholar 

  6. Johnson KW, Torres Soto J, Glicksberg BS, Shameer K, Miotto R, Ali M, et al. Artificial intelligence in cardiology. J Am Coll Cardiol. 2018;71(23):2668–79.

    Article  Google Scholar 

  7. Sengupta PP, Huang YM, Bansal M, Ashrafi A, Fisher M, Shameer K, et al. Cognitive machine-learning algorithm for cardiac imaging: a pilot study for differentiating constrictive pericarditis from restrictive cardiomyopathy. Circ Cardiovasc Imaging. 2016;9(6).

  8. Narula S, Shameer K, Salem Omar AM, Dudley JT, Sengupta PP. Machine-learning algorithms to automate morphological and functional assessments in 2D echocardiography. J Am Coll Cardiol. 2016;68(21):2287–95.

    Article  Google Scholar 

  9. Tabassian M, Sunderji I, Erdei T, Sanchez-Martinez S, Degiovanni A, Marino P, et al. Diagnosis of heart failure with preserved ejection fraction: machine learning of spatiotemporal variations in left ventricular deformation. J Am Soc Echocardiogr. 2018;31(12):1272–84 e9.

    Article  Google Scholar 

  10. Samad MD, Ulloa A, Wehner GJ, Jing L, Hartzel D, Good CW, et al. Predicting survival from large echocardiography and electronic health record datasets: optimization with machine learning. JACC Cardiovasc Imaging 2018. The important study uses a large database of nearly 180,000 patients with more than 300,000 echos. The machine learning algorithm used echo data and clinical data. The ML algorithm had higher accuracy than clinical risk scores with statistical significance.

  11. Haro Alonso D, Wernick MN, Yang Y, Germano G, Berman DS, Slomka P. Prediction of cardiac death after adenosine myocardial perfusion SPECT based on machine learning. J Nucl Cardiol 2018.

  12. Motwani M, Dey D, Berman DS, Germano G, Achenbach S, Al-Mallah MH, et al. Machine learning for prediction of all-cause mortality in patients with suspected coronary artery disease: a 5-year multicentre prospective registry analysis. Eur Heart J. 2017;38(7):500–7.

    PubMed  Google Scholar 

  13. Kang D, Dey D, Slomka PJ, Arsanjani R, Nakazato R, Ko H, et al. Structured learning algorithm for detection of nonobstructive and obstructive coronary plaque lesions from computed tomography angiography. J Med Imaging (Bellingham). 2015;2(1):014003.

    Article  Google Scholar 

  14. Lancaster MC, Salem Omar AM, Narula S, Kulkarni H, Narula J, Sengupta PP. Phenotypic clustering of left ventricular diastolic function parameters: patterns and prognostic relevance JACC Cardiovasc Imaging 2018. Clustering was used with echocardiographic variables to identify high-risk phenotypes in heart failure patients, a very heterogeneous condition. The clustering groups were better able to predict all-cause mortality and cardiac mortality in comparison to conventional classification. This was seen even in propensity analysis. It demonstrated the capability of algorithmic learning to discern natural patterns in the data to cluster patients according to their phenotypic presentation in unsupervised method.

  15. • Betancur J, Commandeur F, Motlagh M, Sharir T, Einstein AJ, Bokhari S, et al. Deep learning for prediction of obstructive disease from fast myocardial perfusion SPECT: a multicenter study. JACC Cardiovasc Imaging. 2018;11(11):1654–63 One of the early studies to use deep learning in nuclear cardiology to predict obstructive coronary disease in relation to total perfusion deficit.

    Article  Google Scholar 

  16. Zhang J, Gajjala S, Agrawal P, Tison GH, Hallock LA, Beussink-Nelson L, et al. Fully automated echocardiogram interpretation in clinical practice. Circulation. 2018;138(16):1623–35.

    Article  Google Scholar 

  17. Zhao Y, Zeng D, Socinski MA, Kosorok MR. Reinforcement learning strategies for clinical trials in nonsmall cell lung cancer. Biometrics. 2011;67(4):1422–33.

    Article  Google Scholar 

  18. Madani A, Ong JR, Tibrewal A, Mofrad MRK. Deep echocardiography: data-efficient supervised and semi-supervised deep learning towards automated diagnosis of cardiac disease. npj Digital Medicine. 2018;1(1).

  19. Douglas PS, Cerqueira MD, Berman DS, Chinnaiyan K, Cohen MS, Lundbye JB, et al. The future of cardiac imaging: report of a think tank convened by the American College of Cardiology. JACC Cardiovasc Imaging. 2016;9(10):1211–23.

    Article  Google Scholar 

  20. Maspero M, Savenije MHF, Dinkla AM, Seevinck PR, Intven MPW, Jurgenliemk-Schulz IM, et al. Dose evaluation of fast synthetic-CT generation using a generative adversarial network for general pelvis MR-only radiotherapy. Phys Med Biol. 2018;63(18):185001.

    Article  Google Scholar 

  21. Shrestha S, Sengupta PP. The mechanics of machine learning: from a concept to value. J Am Soc Echocardiogr. 2018;31(12):1285–7.

    Article  Google Scholar 

  22. Sengupta PP, Adjeroh DA. Will artificial intelligence replace the human echocardiographer? Circulation. 2018;138(16):1639–42.

    Article  Google Scholar 

  23. Shrestha S, Sengupta PP. Machine learning for nuclear cardiology: the way forward. J Nucl Cardiol 2018.

  24. Tan LK, McLaughlin RA, Lim E, Abdul Aziz YF, Liew YM. Fully automated segmentation of the left ventricle in cine cardiac MRI using neural network regression. J Magn Reson Imaging. 2018;48(1):140–52.

    Article  Google Scholar 

  25. van Rosendael AR, Maliakal G, Kolli KK, Beecy A, Al’Aref SJ, Dwivedi A, et al. Maximization of the usage of coronary CTA derived plaque information using a machine learning based algorithm to improve risk stratification; insights from the CONFIRM registry. J Cardiovasc Comput Tomogr. 2018;12(3):204–9.

    Article  Google Scholar 

  26. Winther HB, Hundt C, Schmidt B, Czerner C, Bauersachs J, Wacker F, et al. nu-net: Deep learning for generalized biventricular mass and function parameters using multicenter cardiac MRI data. JACC Cardiovasc Imaging. 2018;11(7):1036–8.

    Article  Google Scholar 

  27. Tan LK, Liew YM, Lim E, McLaughlin RA. Convolutional neural network regression for short-axis left ventricle segmentation in cardiac cine MR sequences. Med Image Anal. 2017;39:78–86.

    Article  Google Scholar 

  28. Dey D, Slomka PJ, Leeson P, Comaniciu D, Shrestha S, Sengupta PP, et al. Artificial intelligence in cardiovascular imaging: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(11:)1317–35.

    Article  Google Scholar 

  29. Sanchez-Martinez S, Duchateau N, Erdei T, Kunszt G, Aakhus S, Degiovanni A, et al. Machine learning analysis of left ventricular function to characterize heart failure with preserved ejection fraction. Circ Cardiovasc Imaging. 2018;11(4):e007138.

    Article  Google Scholar 

  30. Lum PY, Singh G, Lehman A, Ishkanov T, Vejdemo-Johansson M, Alagappan M, et al. Extracting insights from the shape of complex data using topology. Sci Rep. 2013;3:1236.

    Article  CAS  Google Scholar 

  31. Camara PG, Rosenbloom DI, Emmett KJ, Levine AJ, Rabadan R. Topological data analysis generates high-resolution, genome-wide maps of human recombination. Cell Syst. 2016;3(1):83–94.

    Article  CAS  Google Scholar 

  32. Hinks T, Zhou X, Staples K, Dimitrov B, Manta A, Petrossian T, et al. Multidimensional endotypes of asthma: topological data analysis of cross-sectional clinical, pathological, and immunological data. Lancet. 2015;385(Suppl 1):S42.

    Article  Google Scholar 

  33. Hinks TS, Zhou X, Staples KJ, Dimitrov BD, Manta A, Petrossian T, et al. Innate and adaptive T cells in asthmatic patients: relationship to severity and disease mechanisms. J Allergy Clin Immunol. 2015;136(2):323–33.

    Article  CAS  Google Scholar 

  34. Lakshmikanth T, Olin A, Chen Y, Mikes J, Fredlund E, Remberger M, et al. Mass cytometry and topological data analysis reveal immune parameters associated with complications after allogeneic stem cell transplantation. Cell Rep. 2017;20(9):2238–50.

    Article  CAS  Google Scholar 

  35. Li L, Cheng WY, Glicksberg BS, Gottesman O, Tamler R, Chen R, et al. Identification of type 2 diabetes subgroups through topological analysis of patient similarity. Sci Transl Med. 2015;7(311):311ra174.

    Article  Google Scholar 

  36. Nicolau M, Levine AJ, Carlsson G. Topology based data analysis identifies a subgroup of breast cancers with a unique mutational profile and excellent survival. Proc Natl Acad Sci U S A. 2011;108(17):7265–70.

    Article  CAS  Google Scholar 

  37. Nielson JL, Paquette J, Liu AW, Guandique CF, Tovar CA, Inoue T, et al. Topological data analysis for discovery in preclinical spinal cord injury and traumatic brain injury. Nat Commun. 2015;6:8581.

    Article  CAS  Google Scholar 

  38. Torres BY, Oliveira JH, Thomas Tate A, Rath P, Cumnock K, Schneider DS. Tracking resilience to infections by mapping disease space. PLoS Biol. 2016;14(4):e1002436.

    Article  Google Scholar 

  39. Casaclang-Verzosa G, Shrestha S, Khalil M, Cho JS, Tokodi M, Balla S, et al. Network tomography for understanding phenotypic presentations in aortic stenosis. JACC Cardiovasc Imaging 2019 (in press). This is the first study in diagnostic clinical cardiology to demonstrate effective use of patient similarity network. This study uses a novel technique called topological data analysis for the first time in cardiovascular disease. It demonstrates a unique and important method in grouping patients with similar presentation of aortic stenosis while capturing the notion of progression in the disease.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Partho P. Sengupta MD, DM.

Ethics declarations

Conflict of Interest

Karthik Seetharam and Sirish Shrestha each declare no potential conflicts of interest.

Partho P. Sengupta is a consultant for HeartSciences and Ultromics.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on State-of-the-Art Informatics

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seetharam, K., Shrestha, S. & Sengupta, P.P. Artificial Intelligence in Cardiovascular Medicine. Curr Treat Options Cardio Med 21, 25 (2019). https://doi.org/10.1007/s11936-019-0728-1

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11936-019-0728-1

Keywords

Navigation