Heart Diseases

心脏病
  • 文章类型: Journal Article
    冠状病毒(CoV)属于RNA病毒家族。已知该家族中的病毒在人类中引起轻度呼吸道疾病。导致冠状病毒-19疾病(COVID-19)的新型SARS-COV2病毒的起源是中国武汉市,它从那里传播以引起全球大流行。尽管肺部是19型冠状病毒病(COVID-19)的主要靶器官,自从它爆发以来,已知这种疾病会影响心脏,血管,肾,肠,肝脏和大脑。本文旨在总结冠状病毒病-19对心脏和肝脏的灾难性影响及其发病机制。
    本评论中使用的信息来自PubMed上发表的相关文章,谷歌学者,Google,世卫组织网站,CDC和其他来源。使用与COVID-19相关的关键搜索语句和短语来检索信息。原创研究文章,审查文件,研究信函和病例报告被用作信息来源。
    除了造成严重的肺损伤,据报道,COVID-19还影响并导致许多其他器官的功能障碍。COVID-19感染可通过下调膜结合活性血管紧张素转换酶(ACE)来影响人。ACE2表达不足的人更容易感染COVID-19。患者预先存在的合并症是使个体易患严重COVID-19的主要危险因素。
    疾病的严重程度及其广谱表型是直接和间接致病因素综合作用的结果。因此,协调许多治疗偏好的方案应该是使疾病降级并避免由于疾病引起的多器官损伤和功能障碍而导致的死亡的最佳替代方案。
    UNASSIGNED: Coronaviruses (CoVs) belong to the RNA viruses family. The viruses in this family are known to cause mild respiratory disease in humans. The origin of the novel SARS-COV2 virus that caused the coronavirus-19 disease (COVID-19) is the Wuhan city in China from where it disseminated to cause a global pandemic. Although lungs are the predominant target organ for Coronavirus Disease-19 (COVID-19), since its outbreak, the disease is known to affect heart, blood vessels, kidney, intestine, liver and brain. This review aimed to summarize the catastrophic impacts of Coronavirus disease-19 on heart and liver along with its mechanisms of pathogenesis.
    UNASSIGNED: The information used in this review was obtained from relevant articles published on PubMed, Google Scholar, Google, WHO website, CDC and other sources. Key searching statements and phrases related to COVID-19 were used to retrieve information. Original research articles, review papers, research letters and case reports were used as a source of information.
    UNASSIGNED: Besides causing severe lung injury, COVID-19 has also been reported to affect and cause dysfunction of many other organs. COVID-19 infection can affect people by downregulating membrane-bound active angiotensin-converting enzyme (ACE). People who have deficient ACE2 expression are more vulnerable to COVID-19 infection. The patients\' pre-existing co-morbidities are major risk factors that predispose individuals to severe COVID-19.
    UNASSIGNED: The disease severity and its broad spectrum phenotype is a result of combined direct and indirect pathogenic factors. Therefore, protocols that harmonize many therapeutic preferences should be the best alternatives to de-escalate the disease and obviate deaths caused as a result of multiple organ damage and dysfunction induced by the disease.
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  • 文章类型: Journal Article
    虽然许多儿科心脏病学专家强调了姑息治疗的重要性,很少有研究评估专业儿科姑息治疗(SPPC)对心脏病患儿的影响.我们使用与姑息治疗相关的关键词进行了系统评价,生活质量和护理满意度,还有心脏病.我们搜索了PubMed,EMBASE,CINAHL,CENTRAL和WebofScience于2023年12月发布。筛选,数据提取和方法遵循系统评价和荟萃分析(PRISMA)建议的首选报告项目。成对的经过培训的审稿人独立评估了每篇文章。从审查中排除的所有全文均经过手工筛选,以获得合格的参考,包括一般儿科人群的系统审查。两名审稿人独立提取:(1)研究设计;(2)方法;(2)设置;(3)人口;(4)干预/暴露和控制定义;(5)结果措施;(6)结果。在筛选的4059项研究中,9符合纳入标准,包括两个重叠的患者数据。研究设计是异质的,仅包括一项随机对照试验和两项以SPPC作为前瞻性干预的历史对照试验。总的来说,存在中度至高度偏倚风险.七个是单中心研究。在综合估计中,接受SPPC的患者更有可能有预先记录的护理计划(RR2.7,[95CI1.6,4.7],p<0.001)和复苏极限(RR4.0,[2.0,8.1],p<0.001),而生命结束时主动复苏的可能性只有一半([0.3,0.9],p=0.032)。为了父母的压力,与对照组相比,接受SPPC的得分提高了近半个标准差(RR0.48,95CI0.10,0.86)。最终,我们发现缺乏研究SPPC影响的高质量数据;然而,研究结果与其他儿科人群的文献相关。研究结果表明,SPPC整合对心脏病患者及其家人有好处。
    While many experts in pediatric cardiology have emphasized the importance of palliative care involvement, very few studies have assessed the influence of specialty pediatric palliative care (SPPC) involvement for children with heart disease. We conducted a systematic review using keywords related to palliative care, quality of life and care-satisfaction, and heart disease. We searched PubMed, EMBASE, CINAHL, CENTRAL and Web of Science in December 2023. Screening, data extraction and methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Pairs of trained reviewers independently evaluated each article. All full texts excluded from the review were hand-screened for eligible references including systematic reviews in general pediatric populations. Two reviewers independently extracted: (1) study design; (2) methodology; (2) setting; (3) population; (4) intervention/exposure and control definition; (5) outcome measures; and (6) results. Of 4059 studies screened, 9 met inclusion criteria including two with overlapping patient data. Study designs were heterogenous, including only one randomized control and two historical control trials with SPPC as a prospective intervention. Overall, there was moderate to high risk of bias. Seven were single centers studies. In combined estimates, patients who received SPPC were more likely to have advance care planning documented (RR 2.7, [95%CI 1.6, 4.7], p < 0.001) and resuscitation limits (RR 4.0, [2.0, 8.1], p < 0.001), while half as likely to have active resuscitation at end-of-life ([0.3, 0.9], p = 0.032). For parental stress, receipt of SPPC improved scores by almost half a standard deviation (RR 0.48, 95%CI 0.10, 0.86) more than controls. Ultimately, we identified a paucity of high-quality data studying the influence of SPPC; however, findings correlate with literature in other pediatric populations. Findings suggest benefits of SPPC integration for patients with heart disease and their families.
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  • 文章类型: Journal Article
    目的提供欧洲心脏病学会(ESC)和美国心脏病学会/美国心脏协会(ACC/AHA)指南之间心脏MRI适应症的全面头对头比较和时间分析,以确定共识和分歧的领域。材料与方法进行系统评价和荟萃分析。直到2023年5月发布的ESC和ACC/AHA指南对与心脏MRI相关的建议进行了系统筛选。使用χ2或Fisher精确检验比较了两个指南之间以及每个指南的较新版本与较旧版本之间的心脏MRI建议的建议类别(COR)和证据水平(LOE)。结果ESC指南包括109条关于心脏MRI的建议,行政协调会/AHA准则包括90项建议。ACC/AHA指南中CORI和LOEB的比例高于ESC指南(60%[54/90]对46.8%[51/109];P=.06和53%[48/90]对35.8%[39/109],分别为;P=0.01)。随着时间的推移,ESC指南中心脏MRI推荐数量的增加显着增加(ESC从63到109,ACC/AHA从65到90;P=0.03)。达成共识的主要领域是心力衰竭和肥厚型心肌病,虽然主要的分歧是瓣膜性心脏病,心律失常,和主动脉疾病。结论ESC指南包括更多与心脏MRI使用相关的建议,而ACC/AHA建议的COR和LOE较高。在两个指南中,心脏MRI建议的数量随着时间的推移显著增加,表明心脏MRI评估和治疗心血管疾病的作用日益增强。关键词:心血管磁共振,Guideline,欧洲心脏病学会,ESC,美国心脏病学会/美国心脏协会,ACC/AHA补充材料可用于本文。©RSNA,2024.
    Purpose To provide a comprehensive head-to-head comparison and temporal analysis of cardiac MRI indications between the European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines to identify areas of consensus and divergence. Materials and Methods A systematic review and meta-analysis was conducted. ESC and ACC/AHA guidelines published until May 2023 were systematically screened for recommendations related to cardiac MRI. The class of recommendation (COR) and level of evidence (LOE) for cardiac MRI recommendations were compared between the two guidelines and between newer versus older versions of each guideline using χ2 or Fisher exact tests. Results ESC guidelines included 109 recommendations regarding cardiac MRI, and ACC/AHA guidelines included 90 recommendations. The proportion of COR I and LOE B was higher in ACC/AHA versus ESC guidelines (60% [54 of 90] vs 46.8% [51 of 109]; P = .06 and 53% [48 of 90] vs 35.8% [39 of 109], respectively; P = .01). The increase in the number of cardiac MRI recommendations over time was significantly higher in ESC guidelines (from 63 to 109 for ESC vs from 65 to 90 for ACC/AHA; P = .03). The main areas of consensus were found in heart failure and hypertrophic cardiomyopathy, while the main divergences were in valvular heart disease, arrhythmias, and aortic disease. Conclusion ESC guidelines included more recommendations related to cardiac MRI use, whereas the ACC/AHA recommendations had higher COR and LOE. The number of cardiac MRI recommendations increased significantly over time in both guidelines, indicating the increasing role of cardiac MRI evaluation and management of cardiovascular disease. Keywords: Cardiovascular Magnetic Resonance, Guideline, European Society of Cardiology, ESC, American College of Cardiology/American Heart Association, ACC/AHA Supplemental material is available for this article. © RSNA, 2024.
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  • 文章类型: Journal Article
    慢性心脏病(CHD)仍然是全球发病率和死亡率的主要原因。需要有效的治疗干预措施来缓解其进展。Omega-3脂肪酸(FAs)因其在CHD管理中的潜在抗炎和内皮保护特性而受到关注。本研究旨在评估补充Omega-3FA对冠心病患者炎症和内皮功能标志物的疗效。为了实现这一点,我们使用相关关键字搜索国际数据库(WebofScience,PubMed,Embase,和Scopus)和提取物出版物评估补充omega-3FA对冠心病患者炎症标志物和内皮功能的有效性。使用STATA(第15版)以及随机和固定效应模型来评估收集的数据。13项临床试验研究符合纳入标准,总样本量为853人(406例和447例对照)。这些病例的平均年龄为58±10.3岁。汇总结果表明,补充omega-3Omega-3FA可显着降低循环IL-6的水平(SMD=-0.47,95%CI-1.29至0.35,%,p<0.001),hs-CRP(SMD=-0.21,95%CI-0.70至0.28,p=0.01),和TNF-α(SMD=-0.56,95%CI-1.14至0.01,p<0.001)。此外,研究结果显示,每日补充omega-3可显著增加口蹄疫0.34%(95%CI:0.14-0.54%,p<0.001),与CHD患者的固定效应模型相比,与安慰剂相比。这些发现强调了补充omega-3脂肪酸在调节CHD患者炎症和内皮功能障碍中的潜在治疗效用。
    Chronic heart disease (CHD) is still a major global cause of morbidity and mortality, necessitating effective therapeutic interventions to mitigate its progression. Omega-3 fatty acids (FAs) have garnered attention for their potential anti-inflammatory and endothelial-protective properties in CHD management. The present study aims to assess the efficacy of Omega-3 FA supplementation on markers of inflammation and endothelial function in patients with CHD. To achieve this, we used the relevant keywords to search international databases (Web of Science, PubMed, Embase, and Scopus) and extract publications evaluating the effectiveness of omega-3 FA supplementation on inflammation markers and endothelial function in patients with CHD. STATA (version 15) and the random and fixed-effects models were used to evaluate the collected data. Thirteen clinical trial studies met inclusion criteria, with a total sample size of 853 individuals (406 cases and 447 controls). The cases had a mean age of 58 ± 10.3 years. The pooled results indicated that omega-3 Omega-3 FA supplementation significantly reduced the level of circulating IL-6 (SMD = -0.47, 95% CI -1.29 to 0.35, %, p < 0.001), hs-CRP (SMD = -0.21, 95% CI -0.70 to 0.28, p = 0.01), and TNF-α (SMD = -0.56, 95% CI -1.14 to 0.01, p < 0.001) in patients with CHD. Also, findings revealed that a daily supplement of omega-3 significantly increased FMD by 0.34% (95% CI: 0.14-0.54%, p < 0.001) as compared with placebo by a fixed-effect model in patients with CHD. These findings underscore the potential therapeutic utility of omega-3 fatty acid supplementation in modulating inflammation and endothelial dysfunction in patients with CHD.
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  • 文章类型: Systematic Review
    人囊性棘球蚴病(CE)是由tape虫的幼虫期引起的寄生虫感染,主要影响肝脏和肺。尽管在所有CE病例中只有0.02-2%的心脏受到影响,相当多的案例是,并继续,已发布。然而,由于心脏CE的罕见发生以及由此导致的临床试验的缺乏,关于疾病各个方面的知识仍然有限。为了获得更清晰的解剖图像,临床,心脏CE的诊断和治疗方面,我们系统地回顾了1965年至2022年之间发表的文献。受影响的心脏结构的解剖模式遵循供应毛细血管床的延伸。大多数患者(82.7%)有症状,并出现长期的非特异性症状,如呼吸困难,胸痛和心悸。急性并发症通常源于囊肿破裂,发生在18.3%的病例中,表现为栓塞,心包填塞,或过敏反应在83.2%,分别为17.8%和10.9%,分别。至于位于其他器官的CE囊肿,心脏CE的诊断是通过影像学进行的。血清学由于其有限的敏感性而发挥次要作用。与腹部CE囊肿不同,心脏CE囊肿通常切除独立于其阶段(活动/非活动),因为它们的存在会损害心脏性能,并有长期后遗症的风险。超过80%的患者通过单一手术干预进行治疗。我们发现与疾病有关的病死率为11.1%。由于局部复发报告长达108个月,继发性CE报告长达72个月术后,患者应至少随访10年.
    Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is affected in only 0.02-2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years.
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  • 文章类型: Journal Article
    背景:由于引入了直接口服抗凝剂(DOACs)及其与维生素K拮抗剂(VKAs)的比较,关于左心室血栓形成(LVT)的最佳治疗方法的报道存在矛盾的结果.
    目的:在本荟萃分析中,我们打算全面评估这些治疗的安全性和有效性.
    方法:系统搜索了所有比较VKAs与DOAC治疗LVTs的疗效或安全性的临床试验和队列,直至2023年4月15日。
    结果:提取了32项研究的结果,其中4213例患者的合并样本用于荟萃分析。DOAC,尤其是利伐沙班和阿哌沙班,导致更快的分辨率,死亡率较低,在LVT的管理中,并发症(SSE和出血事件)比VKAs少。
    结论:与VKAs相比,DOAC导致左心室血栓形成的更快(仅利伐沙班)和更安全的解决。
    BACKGROUND: Since the introduction of direct oral anticoagulants (DOACs) and their comparison with vitamin K antagonists (VKAs), conflicting results have been reported regarding the optimal treatment for left ventricular thrombosis (LVT).
    OBJECTIVE: In this meta-analysis, we intend to comprehensively evaluate the safety and efficacy of these treatments.
    METHODS: All clinical trials and cohorts that compared the efficacy or safety of VKAs with DOACs in the treatment of LVTs were systematically searched until April 15, 2023.
    RESULTS: The results of 32 studies with a pooled sample size of 4213 patients were extracted for meta-analysis. DOACs, especially rivaroxaban and apixaban, cause faster resolution, lower mortality, and fewer complications (SSE and bleeding events) than VKAs in the management of LVTs.
    CONCLUSIONS: Compared with VKAs, DOACs result in significantly faster (only rivaroxaban) and safer resolution of left ventricular thrombosis.
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  • 文章类型: Journal Article
    目的:人工智能(AI)正在改变心电图(ECG)解释。人工智能诊断可以超越人类能力,便于自动访问细微的心电图解释,扩大人群心血管筛查范围。AI可应用于外部监护仪中的标准12导联静息心电图和单导联心电图,可植入装置,和直接面向消费者的智能设备。我们总结了AI-ECG文献的现状。
    结果:节律分类是AI-ECG的第一个应用。随后,AI-ECG模型已被开发用于筛查结构性心脏病,包括肥厚型心肌病。心脏淀粉样变性,主动脉狭窄,肺动脉高压,左心室收缩功能障碍.Further,AI模型可以预测未来的事件,如收缩性心力衰竭和心房颤动的发展。AI-ECG在急性心脏事件和非心脏应用中表现出潜力,包括急性肺栓塞,电解质异常,监测药物治疗,睡眠呼吸暂停,并预测全因死亡率。心脏监护仪和智能手表领域的许多AI模型已获得食品和药物管理局(FDA)的节律分类许可。而其他人则用于鉴定心脏淀粉样变性,肺动脉高压和左心室功能不全已获得突破性的设备指定。随着AI-ECG模型的不断发展,除了监管监督和货币化挑战之外,周到的临床实施,以简化工作流程,避免信息过载和医疗保健系统压倒性的假阳性结果是必要的。在广泛采用任何AI-ECG模型之前,需要进行研究以证明和验证医疗保健效率的改善和患者预后的改善。
    OBJECTIVE: Artificial intelligence (AI) is transforming electrocardiography (ECG) interpretation. AI diagnostics can reach beyond human capabilities, facilitate automated access to nuanced ECG interpretation, and expand the scope of cardiovascular screening in the population. AI can be applied to the standard 12-lead resting ECG and single-lead ECGs in external monitors, implantable devices, and direct-to-consumer smart devices. We summarize the current state of the literature on AI-ECG.
    RESULTS: Rhythm classification was the first application of AI-ECG. Subsequently, AI-ECG models have been developed for screening structural heart disease including hypertrophic cardiomyopathy, cardiac amyloidosis, aortic stenosis, pulmonary hypertension, and left ventricular systolic dysfunction. Further, AI models can predict future events like development of systolic heart failure and atrial fibrillation. AI-ECG exhibits potential in acute cardiac events and non-cardiac applications, including acute pulmonary embolism, electrolyte abnormalities, monitoring drugs therapy, sleep apnea, and predicting all-cause mortality. Many AI models in the domain of cardiac monitors and smart watches have received Food and Drug Administration (FDA) clearance for rhythm classification, while others for identification of cardiac amyloidosis, pulmonary hypertension and left ventricular dysfunction have received breakthrough device designation. As AI-ECG models continue to be developed, in addition to regulatory oversight and monetization challenges, thoughtful clinical implementation to streamline workflows, avoiding information overload and overwhelming of healthcare systems with false positive results is necessary. Research to demonstrate and validate improvement in healthcare efficiency and improved patient outcomes would be required before widespread adoption of any AI-ECG model.
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  • 文章类型: Systematic Review
    蒽环类抗生素是用于治疗某些类型乳腺癌的最有效的抗肿瘤药物之一,淋巴瘤,和白血病。然而,蒽环类药物诱导剂量依赖性心脏毒性,可能进展为心力衰竭。因此,在接受蒽环类药物治疗的患者中使用早期心功能不全的敏感预测因子有助于早期发现亚临床心功能不全,并有助于启动干预措施以保护这些患者.在心肌测量参数中,心脏磁共振(CMR)测量的天然心肌T1标测被认为是早期亚临床心脏变化的灵敏和准确的定量测量,特别是心脏炎症和纤维化。然而,了解目前支持在蒽环类药物治疗的患者中使用这些措施的证据的质量和有效性,我们旨在对这项措施的临床研究进行系统评价,以检测蒽环类药物治疗癌症患者的早期心肌变化。主要结果是天然T1映射的水平。我们进行了固定效应荟萃分析,并评估了效应估计的确定性。在审查的1780份出版物中(直到2022年),已检索到23个,9条符合纳入标准。我们的研究表明,与健康对照组患者相比(95%CI0.2925至0.7448;p<0.0001),蒽环类药物暴露与天然心肌T1标测比基线显着升高(95%CI0.121至0.5802;p=0.0037)相关。在漏斗图和Egger检验的评估中没有发现明显的发表偏倚。根据Q测试,纳入研究中无显著异质性(I2=0.000%与健康对照,I2=14.0666%与基线).总的来说,我们的研究表明,天然心肌T1标测对于检测癌症患者蒽环类药物诱导的心脏毒性是有用的.
    Anthracycline antibiotic is one of the most effective anti-tumor drugs used to manage certain types of breast cancers, lymphomas, and leukemias. However, anthracyclines induce a dose-dependent cardiotoxicity that may progress to heart failure. Thus, using a sensitive predictor of early cardiac dysfunction in patients treated with anthracyclines can help detect subclinical cardiac dysfunction early and help initiate interventions to protect these patients. Among parameters of myocardial measure, cardiac magnetic resonance (CMR)-measured native myocardial T1 mapping is considered a sensitive and accurate quantitative measure of early subclinical cardiac changes, particularly cardiac inflammation and fibrosis. However, to understand the quality and the validity of the current evidence supporting the use of these measures in patients treated with anthracyclines, we aimed to conduct a systematic review of clinical studies of this measure to detect early myocardial changes in cancer patients treated with anthracyclines. The primary outcome was the level of native T1 mapping. We performed fixed-effects meta-analyses and assessed certainty in effect estimates. Of the 1780 publications reviewed (till 2022), 23 were retrieved, and 9 articles met the inclusion criteria. Our study showed that exposure to anthracycline was associated with a significant elevation of native myocardial T1 mapping from baseline (95% CI 0.1121 to 0.5802; p = 0.0037) as well as compared to healthy control patients (95% CI 0.2925 to 0.7448; p < 0.0001). No significant publication bias was noted on the assessment of the funnel plot and Egger\'s test. According to the Q test, there was no significant heterogeneity in the included studies (I2 = 0.0000% versus healthy controls and I2 = 14.0666% versus baseline). Overall, our study suggests that native myocardial T1 mapping is useful for detecting anthracycline-induced cardiotoxicity in patients with cancer.
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  • 文章类型: Journal Article
    医学和外科的进步提高了获得性和先天性心脏病(CHD)儿童的生存率。但是神经系统发病率的负担很高。与冠心病相关的脑部疾病包括白质损伤,中风,癫痫发作,和神经发育迟缓。虽然遗传和疾病特异性因素在早期脑损伤中起着重要作用,心脏病的治疗管理增加了风险。人们对了解如何减少心脏疾病的脑损伤和改善神经发育结果越来越感兴趣。儿科神经科医师在管理这些复杂患者的护理团队中发挥着至关重要的作用,提供神经监测和成像的解释,管理神经紧急情况,协助神经预后,并确定未来的研究目标。
    Medical and surgical advancements have improved survival in children with acquired and congenital heart disease (CHD), but the burden of neurological morbidity is high. Brain disorders associated with CHD include white matter injury, stroke, seizure, and neurodevelopmental delays. While genetics and disease-specific factors play a substantial role in early brain injury, therapeutic management of the heart disease intensifies the risk. There is a growing interest in understanding how to reduce brain injury and improve neurodevelopmental outcomes in cardiac diseases. Pediatric neurologists serve a vital role in care teams managing these complex patients, providing interpretation of neuromonitoring and imaging, managing neurologic emergencies, assisting with neuro prognostication, and identifying future research aims.
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  • 文章类型: Journal Article
    超声心动图是用于诊断心脏病的复杂的超声成像技术。经胸超声心动图,最普遍的类型之一,有助于评估重大心脏病。然而,解释其结果在很大程度上依赖于临床医生的专业知识。在这种情况下,人工智能已经成为帮助临床医生的重要工具。这项研究批判性地分析了使用深度学习技术来自动化经胸超声心动图分析并支持临床判断的关键最新研究。我们系统地组织和分类文章,为视图分类提供解决方案,增强图像质量和数据集,心脏结构的分割和识别,检测心功能异常,和心功能的量化。我们比较了每个类别中各种深度学习方法的性能,找出最有前途的方法。此外,我们强调了当前研究的局限性,并探索了未来探索的有希望的途径。这些包括解决普遍性问题,结合新的人工智能方法,处理罕见心脏病的分析。
    An echocardiogram is a sophisticated ultrasound imaging technique employed to diagnose heart conditions. The transthoracic echocardiogram, one of the most prevalent types, is instrumental in evaluating significant cardiac diseases. However, interpreting its results heavily relies on the clinician\'s expertise. In this context, artificial intelligence has emerged as a vital tool for helping clinicians. This study critically analyzes key state-of-the-art research that uses deep learning techniques to automate transthoracic echocardiogram analysis and support clinical judgments. We have systematically organized and categorized articles that proffer solutions for view classification, enhancement of image quality and dataset, segmentation and identification of cardiac structures, detection of cardiac function abnormalities, and quantification of cardiac functions. We compared the performance of various deep learning approaches within each category, identifying the most promising methods. Additionally, we highlight limitations in current research and explore promising avenues for future exploration. These include addressing generalizability issues, incorporating novel AI approaches, and tackling the analysis of rare cardiac diseases.
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