These Côte d'Azur cardiologists use artificial intelligence to know if the heart is suffering

Anthony (1) he is 70 years old. Hypertensive, smoker, however he is very active and shows no symptoms of cardiovascular disease.

However, his attending physician, as a precautionary measure, found it useful to prescribe a corona virus, a CT scan that allows you to visualize the heart and the arteries of the heart (coronary arteries) in a non-invasive way. The aim is to verify, taking into account the risk factors presented by Antoine, that he does not have coronary heart disease, the most common form of heart disease associated with narrowing (narrowing) of the blood vessels. The test, carried out at the Institut Arnault Tzanck (IAT) in Saint-Laurent-du-Var, will reveal that the anterior interventricular artery (a branch of the left coronary artery) is partially blocked. Therefore, Antoine will have to undergo an additional test, invasive this time, a coronary angiogram that will finally show that this narrowing has no effect on the blood circulation in the heart. And that therefore it is not necessary to undergo intervention. a simple medical treatment will be prescribed.

In Antoine's particular case, would it be possible to avoid the coronary angiography and allow him to return home after the coronary angiography? Yes. This is the proof that the Ds have just providedRs Julien Adjedj and Pierre Amiens, interventional cardiologists at IAT, assisted by Dr Yann Dascorn, radiologist specializing in cardiovascular imaging. A conclusion drawn from years of research in an area of ​​the future: artificial intelligence related to cardiology. “We participated in the development of an algorithm that allows, based on the images provided by the coronavirus, to evaluate the effect of strictures on the blood circulation”the doctors announce.

Inconceivable anomalies

An algorithm that should revolutionize the management of patients presenting with CT abnormalities “inconclusive”a very common situation as explained by Dr Adj. “Coronavirus is very good in negative predictive values: clearly, when the test is normal, it is very reliable and the patient can go home in peace. There is no doubt even in cases of very serious images, severe ischemia: coronary angiography is On the other hand , in many patients, it is difficult to draw a conclusion: the coronavirus accentuates the interstitial stenoses and it is difficult to decide whether to continue the treatment: medical treatment or revascularization through stenting or surgery. Then, a control coronary angiography should be performed, with ischemia tests, the most reliable of which is FFR, which makes it possible to quantify the effect of constriction-induced blood flow pressure'.

As part of an international study, involving the only group of interventional cardiologists of Saint Laurentin in France, images from FFR examinations were used to train a deep learning algorithm capable of rapidly assessing this FFR during the coronavirus, without additional examination, and to show whether the lesion is ischemic (causing pain in the heart), to what extent and what follow-up should be given to the examination.

Answer in 30 minutes

“It is a real revolution; from a single examination of about thirty minutes, the coronavirus, we have both anatomical and functional information. We are today the first in France to use this algorithm which will allow us to indicate to the patient, at the end of the examination , how we will treat it, in which area, even which stent will be placed in the end… This is the future that is underway.”

1. The first name has changed.

2. Basic examination, performed during coronary angiography, to determine whether the narrowing of the coronary vessels requires intervention. It uses an intracoronary pressure measurement guide.

3. Funded by the IAT Establishment, thanks to donations in particular, as part of calls for expressions of interest, this innovative, strategic and forward-looking project for interventional cardiology, was also financially supported by the Council Department under AAP health 2023 and by ARS .

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