Predicting Heart Failure with AI A New Era in Healthcare #pencis#cardiol...

           Predicting Heart Failure with AI A New Era in Healthcare

"Predicting Heart Failure with AI: A New Era in Healthcare" explores how artificial intelligence is transforming cardiovascular care by predicting heart failure risks with unparalleled accuracy. Leveraging vast datasets and machine learning algorithms, AI systems can analyze patient history, lifestyle factors, genetic predispositions, and real-time health data to identify patterns leading to heart failure. This predictive power enables early intervention, personalized treatment plans, and preventive measures, significantly improving patient outcomes and reducing healthcare costs. Embracing AI in cardiac care signals a promising future where proactive healthcare can save lives and create a healthier society.

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     Study shows high rates of unrecognized heart valve                                     disease in healthy seniors

The sheer scale of undiagnosed heart valve disease in our ageing population has been revealed for the first time, thanks to new research led by the University of East Anglia. 

More than a quarter of healthy and symptom-free over 60s examined in the study were found to have previously undetected heart valve disease. 

Co-lead author Vassilios Vassiliou, Clinical Professor of Cardiac Medicine at UEA's Norwich Medical School, said: "This study focused on understanding how widespread heart valve issues of any severity are among healthy, symptom-free adults without any known heart diseases. 

"We examined almost 4,500 individuals aged 60 and older from three regions in the UK: Norfolk, West Midlands, and Aberdeen, using echocardiography, which is an ultrasound of the heart. 

"Our findings showed that more than 28pc of these adults had some form of heart valve disease, although reassuringly it was only mild in the majority of the cases. 

"The data also indicated that age was the main factor associated with these heart valve problems, meaning that the older a person is, the higher their chance of having a significant valve issue." 

Blood flows around the heart and the rest of the body in one direction, like a one-way traffic system. 

The four heart valves (pulmonary and tricuspid on the right side, and aortic and mitral on the left side of the heart) control the direction of the blood flow ensuring optimal pumping of the heart.  

"These problems can put extra strain on the heart and make the heart work harder. Over time, it can increase the risk of having a heart attack, stroke and other heart conditions." 

Symptoms can include feeling breathless, chest pain, feeling weak or dizzy, swollen ankles and feet, feeling more tired than usual and chest or neck palpitations. 

Between 2007 and 2016, a total of 10,000 asymptomatic patients, over the age of 60, were invited through their general practices to take part in the study, which was funded by the British Heart Foundation. 

Of those, 5,429 volunteered to participate, of whom 4,237 were eligible for inclusion. 

They were evaluated with a health questionnaire, clinical examination and transthoracic echocardiography, which is an ultrasound of the heart. 

Heart valve disease was diagnosed in 28.2pc. The prevalence of clinically significant valvular heart disease was reassuringly only 2.4pc, with one in 42 of the over-60s found to have a moderate or severe case, rising to one in 15 for those aged 75 and older. 

However, only 21pc - 900 of the 4,237 patients evaluated - were 75 or over and only 8.6pc were over the age of 80. 

Prof Vassiliou said: "The diagnosis of heart valve disease mostly relies on transthoracic echocardiography, however this is normally only carried out if symptoms are reported or if an unusual murmur is heard during a physical examination. 

"This can be challenging in the elderly because mild symptoms may be masked by reduced physical activity and impaired mobility. 

"This study reveals that many older adults have heart valve issues, even if they don't show any symptoms and we would suggest that if people do develop any new symptoms or signs that could indicate heart disease to discuss this with their doctor. 

"As our population ages, this information can help healthcare providers understand the scale of valve disease and streamline routine care methods and screening programs to ensure that we can cope with the demand in the future. 

"This way, they can better identify and help those at risk before problems become serious." 

The researchers say further studies are needed to clarify the prevalence of the disease in the elderly population and how screening could be used to help identify and manage the disease. 

James Leiper, Associate Medical Director at the British Heart Foundation, said: "This important research using a very large group of people without symptoms showed that over a quarter of participants had a previously undetected heart valve condition. 

"Further research will be required to build on these strong foundations and develop methods to test the feasibility of disease identification in these individuals. 

"Whilst we have made strides, there is still more to be done to eradicate heart disease for good. It is essential that we keep funding lifesaving research, so fewer people have to go through heart break." 

The research also involved the Norfolk and Norwich University Hospital, Aberdeen Royal Infirmary, University of Aberdeen, University of Birmingham, the Royal Brompton Hospital, London, and Imperial College London. 

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                             Fixing a leaky tricuspid valve

The heart's four valves open and shut in a carefully timed sequence to move blood through and out of the heart to the body. But the leaflets (flaps of tissue that make up the valves) and nearby structures don't always function as they should. Heart valve problems fall into two main categories:

Regurgitation (also known as leakage or insufficiency). The valve leaflets do not close properly, causing blood to flow backward each time the heart contracts.

Stenosis (narrowing). The valve leaflets become thick and stiff, so the valve doesn't open as wide as it should to allow blood to pass through.

Both problems can arise simultaneously in the same valve, and more than one valve may be affected. Malfunctioning heart valves can have serious consequences, potentially hampering the heart's ability to pump sufficient amounts blood throughout the body.

Once referred to as the forgotten valve, the tricuspid valve has been getting more attention of late. Earlier this year, the FDA approved two catheter-based devices for repairing a leaky tricuspid valve (see "Understanding heart valve disease"). Both devices have been shown to relieve symptoms and improve quality of life for people with moderate to severe tricuspid regurgitation, which affects about 4% of people ages 75 and older.

The two valves on the left side of the heart (the aortic and mitral valves) are more likely to develop problems than the tricuspid valve, which separates the upper-right and lower-right chambers of the heart. But that's just one reason that tricuspid valve problems have been underappreciated, says Dr. Pinak B. Shah, executive director of interventional and structural heart services at Harvard-affiliated Brigham and Women's Hospital. "People can have a lot of leakage from the tricuspid valve for a long period of time before they start showing any symptoms," he says.

Causes and symptoms

A range of issues can cause the tricuspid valve to malfunction, including inborn structural problems, heart infections, or conditions (most notably, longstanding atrial fibrillation) that cause the base of the valve to widen. When the valve leaks, blood can flow backward into the right atrium, causing the heart to pump harder. Over time, the heart enlarges and struggles to function normally.

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New Algorithm to Distinguish Ventricular Pre Excited Arrhythmia Rhythms ...

              New Algorithm to Distinguish Ventricular Pre Excited Arrhythmia Rhythms

Ventricular Pre-Excited Arrhythmia is a type of abnormal heart rhythm that occurs when electrical signals bypass the normal route through the heart's conduction system, leading to early (pre-excited) activation of the ventricles. Distinguishing this condition from other types of arrhythmias, such as Ventricular Tachycardia (VT) or Supraventricular Tachycardia (SVT) with aberrant conduction, is critical for appropriate management. The development of a new algorithm in this context would typically focus on analyzing ECG (Electrocardiogram) data to enhance accuracy in identifying pre-excitation, ensuring timely diagnosis, and guiding treatment strategies. Key Features of the Algorithm: ECG Pattern Recognition: The algorithm would use advanced pattern recognition techniques to identify the distinguishing features of pre-excitation, such as short PR intervals, delta waves (in cases of WPW Syndrome), and rapid ventricular response. Machine Learning (ML) Integration: Leveraging ML models trained on large datasets of arrhythmic ECG recordings to classify arrhythmias with a high degree of precision. The algorithm could differentiate between ventricular and supraventricular origins of arrhythmia by evaluating complex signal patterns. Real-time Analysis: Implementing real-time analysis in emergency or clinical settings to quickly differentiate pre-excited rhythms from other potentially life-threatening arrhythmias. Improved Specificity and Sensitivity: Enhancements in specificity (correctly identifying true cases of ventricular pre-excitation) and sensitivity (minimizing false negatives) compared to traditional algorithms used in arrhythmia classification. Clinical Decision Support: Integration with clinical decision support systems to provide recommendations for treatment, such as the need for catheter ablation or pharmacological intervention, based on the type of arrhythmia detected. Potential Benefits: Reduced Misdiagnosis: By accurately distinguishing pre-excited rhythms, the algorithm could prevent misdiagnosis, such as confusing pre-excited SVT with VT. Timely Intervention: Faster identification could lead to more appropriate and timely treatment, improving patient outcomes in acute settings. Personalized Treatment: Tailoring treatment strategies based on the precise identification of the arrhythmia, reducing unnecessary treatments and associated risks. More info : cardiology.pencis.com Contact : cardiology@pencis.com #ArrhythmiaDetection #PreExcitedArrhythmia #VentricularArrhythmia #ECGAnalysis #Electrophysiology #HeartRhythmDisorders #CardiacAlgorithms #MedicalAI #MachineLearningInMedicine #CardiovascularInnovation #DigitalHealth #CardiacElectrophysiology #ArrhythmiaManagement #CardiacTech

Tech Enhanced Rehab for Heart Patients: A Game Changer? #pencis #cardiol...

       Tech Enhanced Rehab for Heart Patients: A Game Changer?

Tech-enhanced rehabilitation for heart patients is revolutionizing the way post-cardiac care is delivered. Through wearable devices, telemedicine, AI-driven monitoring, and personalized apps, patients now have access to continuous support and tailored care plans from the comfort of their homes. These technologies provide real-time tracking of vital signs, such as heart rate, blood pressure, and oxygen levels, allowing healthcare providers to monitor progress, detect early signs of complications, and adjust rehabilitation protocols accordingly. Virtual rehab sessions and gamified exercise routines increase patient engagement and adherence to treatment plans, making recovery more efficient and effective. With the integration of artificial intelligence, predictive analytics, and machine learning, tech-enhanced rehab can predict patient risks and outcomes, ensuring timely interventions. This approach is transforming the traditionally clinic-bound rehab into a dynamic, accessible, and patient-centered experience. The result is better health outcomes, reduced hospital readmissions, and an overall improvement in quality of life for cardiac patients. More info : cardiology.pencis.com Contact : cardiology@pencis.com #CardiacRehab #HeartHealthTech #WearableHealth #Telemedicine #AIinHealthcare #TechRevolutionInRehab #RemotePatientMonitoring #DigitalHealth #GamifiedRecovery #HealthcareInnovation #PatientCenteredCare #FutureOfMedicine

                      Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle becomes thickened, also called hypertrophied. The thickened heart muscle can make it harder for the heart to pump blood.

Many people with hypertrophic cardiomyopathy don't realize they have it. That's because they have few, if any, symptoms. But in a small number of people with HCM, the thickened heart muscle can cause serious symptoms. These include shortness of breath and chest pain. Some people with HCM have changes in the heart's electrical system. These changes can result in life-threatening irregular heartbeats or sudden death.

Symptoms

Symptoms of hypertrophic cardiomyopathy can include one or more of the following:

• Chest pain, especially during exercise.
• Fainting, especially during or just after exercise or other physical activity.
• Sensation of fast, fluttering or pounding heartbeats called palpitations.
• Shortness of breath, especially during exercise.

When to see a doctor

Many conditions can cause shortness of breath and fast, pounding heartbeats. It's important to get a prompt checkup to find the cause and receive the right care. See your healthcare professional if you have a family history of HCM or any symptoms related to hypertrophic cardiomyopathy.

Call 911 or your local emergency number if you have any of the following symptoms for more than a few minutes:

• Rapid or irregular heartbeat.
• Trouble breathing.
• Chest pain.

• Causes

  Hypertrophic cardiomyopathy usually is caused by changes in genes that cause the heart muscle to thicken.

  Hypertrophic cardiomyopathy typically affects the wall between the two bottom chambers of the heart. This wall is called the septum. The chambers are called the ventricles. The thickened wall might block blood flow out of the heart. This is called obstructive hypertrophic cardiomyopathy.

  If there's no significant blocking of blood flow, the condition is called nonobstructive hypertrophic cardiomyopathy. But the heart's main pumping chamber, called the left ventricle, might stiffen. This makes it hard for the heart to relax. The stiffness also lessens the amount of blood the ventricle can hold and send to the body with each heartbeat.

  Heart muscle cells also become arranged differently in people with hypertrophic cardiomyopathy. This is called myofiber disarray. It can trigger irregular heartbeats in some people.

  Risk factors

  Hypertrophic cardiomyopathy usually is passed down through families. That means it's inherited. People with one parent with hypertrophic cardiomyopathy have a 50% chance of having the gene change that causes the disease.

  Parents, children, or brothers or sisters of a person with hypertrophic cardiomyopathy should ask their healthcare team about screening tests for the disease.

  Complications

  Complications of hypertrophic cardiomyopathy can include:

  • Atrial fibrillation (AFib). A thickened heart muscle and changes in the structure of heart cells can trigger an irregular and often very rapid heartbeat called AFib. AFib also raises the risk of blood clots, which can travel to the brain and cause a stroke.
  • Blocked blood flow. In many people, the thickened heart muscle blocks the blood flow leaving the heart. This can cause shortness of breath with activity, chest pain, dizziness and fainting spells.
  • Mitral valve disease. If the thickened heart muscle blocks the blood flow leaving the heart, the valve between the left heart chambers might not close properly. That valve is called the mitral valve. If it doesn't close properly, blood can leak backward into the left upper chamber. This is a condition called mitral valve regurgitation. It might make hypertrophic cardiomyopathy symptoms worse.
  • Dilated cardiomyopathy. In a small number of people with HCM, the thickened heart muscle becomes weak and doesn't work well. The condition tends to start in the left lower heart chamber. The chamber becomes larger. The heart pumps with less force.
  • Heart failure. Over time, the thickened heart muscle can become too stiff to fill the heart with blood. As a result, the heart can't pump enough blood to meet the body's needs.
  • Fainting, also called syncope. An irregular heartbeat or blockage of blood flow can sometimes cause fainting. Unexplained fainting can be related to sudden cardiac death, especially if it's happened recently and in a young person.
  • Sudden cardiac death. Rarely, hypertrophic cardiomyopathy can cause heart-related sudden death in people of all ages. Many people with hypertrophic cardiomyopathy don't realize they have it. As a result, sudden cardiac death might be the first sign of the condition. It can happen in young people who seem healthy, including high school athletes and other young, active adults.

  Prevention

  There is no known way to prevent hypertrophic cardiomyopathy (HCM). It's important to find the condition with tests as early as possible to guide treatment and prevent complications.

  Hypertrophic cardiomyopathy usually is passed down in families. If you have a parent, brother, sister or child with hypertrophic cardiomyopathy, ask your healthcare team if genetic screening is right for you. But not everyone with HCM has a gene change that tests can detect. Also, some insurance companies may not cover genetic testing.

  If genetic testing isn't done, or if the results aren't helpful, screening may be done with repeated echocardiograms. Echocardiograms use sound waves to make pictures of the heart.

  For people who have a family member with hypertrophic cardiomyopathy:

  • Echocardiogram screenings are recommended starting at about age 12.
  • Screening with echocardiograms should continue every 1 to 3 years through ages 18 to 21.
  • After that, the screenings can be done every five years through adulthood.

  You may need to have an echocardiogram more often based on your overall health and healthcare team's preference.

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               Rebuilding heart health: The vital role of cardiac                                   rehabilitation in recovery and wellness

India has the dubious distinction of being the heart disease and diabetes capital of the world. Heart disease is the leading cause of death, and what’s most worrying is it strikes Indians, during the prime years of their life. The cardiovascular disease epidemic in Indians is characterized by a higher relative risk burden, an earlier age of onset, higher case fatality and higher premature deaths.

After any heart event, the post-care and rehabilitation is a vital part of the process. A structured program is crucial to get the patient on the path to recovery, and to prevent further illness. The term cardiac rehabilitation, as defined by the World Health Organization (WHO) refers to coordinated, multifaceted interventions designed to optimize a cardiac patient’s physical, psychological, and social functioning, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic processes, thereby reducing risk of further disease.

The goals of cardiac rehabilitation are:
- To help the person get back to his or her normal routine, as quickly and safely as possible

- To institute lifestyle changes and regular monitoring to reduce future risk of cardiac events.
- To improve the psychological well being of the cardiac patient.
What does the research show?
Extensive research has been done, which shows that when compared with usual medical care, patients who underwent cardiac rehabilitation, showed a reduction of 20% in total death and 26% in cardiac deaths. In fact, such is the importance, that leading Cardiology associations, such as the

American Heart Association, have classified it as a Class I recommendation, on par with other life saving measures, such as a daily aspirin dose.

When does cardiac rehabilitation start?
The outpatient program begins one to four weeks after the patient is discharged, and the sutures are removed (for those who have had surgery). The program is usually conducted three days a week and lasts for three to six months depending on the patient’s condition.
What happens during the program?
The patient exercises using portable heart monitoring equipment, known as telemetry. With the help of this special equipment the ECG is continuously transmitted to the monitoring station wirelessly, while the person is exercising. This ensures that the optimal amount of exercise is performed in the safest manner possible.
An individualized program of lifestyle modification, including nutrition, stress reduction and counseling is planned for the patient. Diet forms an important part of a healthy lifestyle and great emphasis is taken to ensure that the patient has a diet plan which is individualized to their needs.
Cure the disease, don’t just repair it:
Heart disease is caused by the presence of risk factors. During cardiac rehabilitation, great emphasis is placed on educating the patient on his/her risk factors and ways to reduce them. This helps attack the actual root of the problem.
Many cardiac rehabilitation programs also include meditation and yoga, which greatly benefit patients, through stress reduction.
Cardiac rehabilitation in India:
Unfortunately, at the present moment, there isn’t sufficient attention given to cardiac rehabilitation, and there are very few centers across the country. There is an urgent need to increase their presence, both to cater to those with heart disease, and to serve as preventive programs for those who have not suffered, but are at high risk.

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             Women less likely to survive heart surgery                                                  complications than men

Women are more likely to die from complications following cardiovascular surgery than men, according to a new analysis published in JAMA Surgery.[1]

The study’s authors explored data from more than 860,000 Medicare beneficiaries who underwent a high-risk cardiac or vascular surgery from October 2015 to February 2020. Surgeries included abdominal aortic aneurysm repair, coronary artery bypass grafting, surgical aortic valve replacement and mitral valve replacement/repair. 

Overall, 35.2% of patients included in the study were women. The mean ages were 74.8 years old for those female patients and 73.4 years old for the study’s male patients. In addition, female patients were less likely to have an unplanned surgery, but more likely to present with two or more comorbidities. 

For the sake of this analysis, serious complications were defined as any postoperative complication that resulted in an extended length of stay. Examples of such complications include myocardial infarction, pulmonary embolism, pulmonary failure, pneumonia, surgical site infections and more. 

The group found that the serious complication rates were nearly identical for male and female patients—14.98% vs. 14.37%, respectively. However, 30-day mortality was 4.22% for female patients and 3.34% for male patients. In addition, failure to rescue rates were 10.71% for female patients and 8.58% for male patients, and reoperation was slightly more common among male patients.

“This is an issue for the entire United States healthcare system: we are failing to rescue women after high-risk surgery even though the rate of postoperative complication is similar to men,” first author Catherine M. Wagner, MD, MSc, an integrated thoracic surgery resident at University of Michigan Health (U-M Health), said in a prepared statement. “There needs to be improved recognition and response to these complications if we are to narrow the sex disparities after high risk surgery.”

“These high risk procedures are inherently expected to have higher complication rates, but patients are still expected to have a positive outcome if the complication is managed quickly,” added co-author Gorav Ailawadi, MD, MBA, chair of cardiac surgery at U-M Health and a director of the University of Michigan Health Frankel Cardiovascular Center. “In our study, female patients had a lower rate of reoperation than males. This may not be due to a lower need for reoperation, it could instead be a signal that their complications were not appropriately addressed.”

The authors wrote that it is important for all healthcare providers to be aware of “implicit biases.” Specific training may be required. The group also emphasized that continuing to examine outcomes by sex “can help address the longstanding neglect of women’s health in research, uncover disparities and identify underlying mechanisms that, if addressed, can improve outcomes for all patients.” 

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