Intelligent Prediction of Cryptogenic Stroke Using Patent Foramen Ovale from TEE Imaging Data and Machine Learning Methods

A novel intelligent grade classification architecture for Patent Foramen Ovale by Contrast Transthoracic Echocardiography based on deep learning

Patent foramen ovale (PFO) is one of the main causes of ischemic stroke. Due to the complex characteristics of contrast transthoracic echocardiography (cTTE), PFO classification is time-consuming and laborious in clinical practice. For this reason, a variety of PFO diagnostic models have been presented based on machine learning in recent years. However, existing models have lower diagnostic accuracy due to similar gray values of microbubbles and surrounding myocardial tissue in cTTE. Meanwhile, the greater volume of right-to-left shunt (RLS) volume leads to a higher incidence of migraine and stroke. Existing models do not quantify the severity of RLS, which affects the use of treatment methods in later clinical treatment. To solve these problems, we propose TVUNet++ for left ventricular segmentation and ULSAM-ResNet for PFO classification. More specifically, TVUNet++ can distinguish various local features in cTTE through learnable affinity maps and implicitly capture the semantic relationship between the left heart cavity and the background region. In addition, we provide a benchmark cTTE dataset to evaluate the performance of the proposed model through various experiments. Experimental results show that the average Dice Coefficient of the proposed model can reach 92.11%. Moreover, ULSAM-ResNet can realize multi-scale and multi-frequency feature learning through multiple subspaces and learn cross-channel information for accurate grade classification efficiently. The average recall of static cTTE can reach 84.27%. Furthermore, the proposed model outperforms state-of-the-art models in the grade classification of PFO.

Clinical applications of artificial intelligence and machine learning in neurocardiology: a comprehensive review

Neurocardiology is an evolving field focusing on the interplay between the nervous system and cardiovascular system that can be used to describe and understand many pathologies. Acute ischemic stroke can be understood through this framework of an interconnected, reciprocal relationship such that ischemic stroke occurs secondary to cardiac pathology (the Heart-Brain axis), and cardiac injury secondary to various neurological disease processes (the Brain-Heart axis). The timely assessment, diagnosis, and subsequent management of cerebrovascular and cardiac diseases is an essential part of bettering patient outcomes and the progression of medicine. Artificial intelligence (AI) and machine learning (ML) are robust areas of research that can aid diagnostic accuracy and clinical decision making to better understand and manage the disease of neurocardiology. In this review, we identify some of the widely utilized and upcoming AI/ML algorithms for some of the most common cardiac sources of stroke, strokes of undetermined etiology, and cardiac disease secondary to stroke. We found numerous highly accurate and efficient AI/ML products that, when integrated, provided improved efficacy for disease prediction, identification, prognosis, and management within the sphere of stroke and neurocardiology. In the focus of cryptogenic strokes, there is promising research elucidating likely underlying cardiac causes and thus, improved treatment options and secondary stroke prevention. While many algorithms still require a larger knowledge base or manual algorithmic training, AI/ML in neurocardiology has the potential to provide more comprehensive healthcare treatment, increase access to equitable healthcare, and improve patient outcomes. Our review shows an evident interest and exciting new frontier for neurocardiology with artificial intelligence and machine learning.