The diagnostic value of chest X-ray scanning by the help of Artificial Intelligence in Heart Failure (ART-IN-HF).

BACKGROUND: Typical signs of heart failure (HF), like increased cardiothoracic ratio (CTR) and pleural effusion, can be seen on X-ray. Artificial Intelligence (AI) can help in the early and quicker diagnosis of HF. OBJECTIVES: The study's goal was to demonstrate that the AI interpretation of chest X-rays can assist the clinician in diagnosing HF. METHODS: Patients older than 45 years were included in the study. The study analyzed 10 100 deidentified outpatient chest X-rays by AI algorithm. The AI-generated report was later verified by an independent radiologist. Patients with CTR > 0.5 and pleural effusion were marked as potential HF. Flagged patients underwent confirmatory tests, and those labeled as negative also underwent further investigations to rule out HF. RESULTS: Out of 10 100, the AI algorithm detected 183 (1.8%) patients with increased CTR and pleural effusion on chest X-rays. One hundred and six out of 183 underwent diagnostic tests. Eighty-two (77%) out of 106 were diagnosed with HF according to current guidelines. From the remaining 9917 patients, 106 patients were randomly selected. Nine (8%) out of them were diagnosed with HF. The positive predictive value of AI for diagnosing HF is 77%, and the negative predictive value is 91%. More than half (54.9%) of newly diagnosed patients had HF with preserved ejection fraction. CONCLUSION: HF is a risky condition with nonspecific symptoms that are difficult to diagnose, especially in the early stages. Using AI assistance for X-ray interpretation can be helpful for early diagnosis of HF especially HF with preserved ejection fraction.

Relationship Between Urinary Angiotensinogen and Mortality in Patients with Heart Failure with Reduced Ejection Fraction.

BACKGROUND: Activation of the reninangi otens in-aldosterone system has an important role in the pathophysiology of heart failure with reduced ejection fraction. While the effects of systemic reninangi otens in-aldosterone system activation on heart failure with reduced ejection fraction are well known, the impact of the local reninangi otens in-aldosterone system on heart failure with reduced ejection fraction is not fully understood because of limited clinical research. This study aimed to investigate the effect of urinary angiotensinogen level, an accepted indicator of local reninangi otens in-aldosterone system activation, on all-cause mortality in patients with heart failure with reduced ejection fraction. METHODS: This retrospective, single-center study included 60 patients with baseline urinary angiotensinogen data and survival/mortality data at 4 years. Urinary angiotensinogen values were standardized to the urinary creatinine value measured from the same urine sample. The median urinary angio tensi nogen /urin ary creatinine value among all patients (114 µg/g) was used as a cutoff to divide the patients into 2 groups. Mortality data were obtained from the national registry systems or by telephone. RESULTS: Comparison of all-cause mortality in the 2 groups showed that 22 deaths (71%) occurred in the group with a urinary angio tensinogen/urinary creatinine ratio above the median and 10 deaths (35.5%) occurred in the group of patients with urinary angio tensinogen/urinary creatinine equal to or below the median value (P =.005). CONCLUSION: Our study suggests that urinary angiotensinogen can be used as a new biomarker in the prognosis and follow-up of heart failure patients.

A Novel Indicator of Myocardial Injury after Acute Myocardial Infarction: 'DPP-3'.

BACKGROUND: Dipeptidyl peptidase 3 (DPP-3) is an intracellular enzyme that causes hemodynamic instability and cardiac depression in several cases such as cardiogenic shock, sepsis and burns where DPP-3 is released into the blood due to cell death. Data on the effect of higher DPP-3 levels on acute coronary syndrome (ACS) patients are currently lacking. The aim of this study was to evaluate the effect of DPP-3 levels on ACS patients. METHODS: In this prospective study, we included ACS patients including STEMI and non-STEMI groups and a control group to compare various demographic, echocardiographic and laboratory parameters including DPP-3. DPP-3 levels were measured at 24th, 48th, and 72nd h from the onset of symptoms in ACS patients and then compared with left ventricle ejection fraction (LVEF) for the assessment of left ventricle systolic function. RESULTS: A total of 70 ACS patients (age 62.5 ± 11 years, 68.6% male) were recruited and 48 normal individuals were included as control group (age 61.1 ± 10 years, 66.7% male). It has been demonstrated that DPP-3 levels are significantly higher in the ACS group than the control group like troponin I levels. DPP-3 levels were found to be one of the independent predictors of LVEF similar to NT-proBNP and troponin I. CONCLUSIONS: This study suggests that DPP-3 could be an important indicator of myocardial depression predicting left ventricle systolic function in ACS.