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Article ; Online: Is Left Ventricular Stroke Work Index Useful in the Cardiac Intensive Care Unit?

Clark, Katherine A A / McNamara, Robert L

2020 Volume 13, Issue 11, Page(s) e012002

MeSH term(s)	Echocardiography ; Humans ; Intensive Care Units ; Stroke/diagnostic imaging ; Ventricular Function, Left
Language	English
Publishing date	2020-11-16
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2435045-X
ISSN	1942-0080 ; 1941-9651
ISSN (online)	1942-0080
ISSN	1941-9651
DOI	10.1161/CIRCIMAGING.120.012002
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Article ; Online: Stress Echocardiography.

Soufer, Aaron / McNamara, Robert L

Circulation. Cardiovascular imaging

2019 Volume 12, Issue 6, Page(s) e009318

MeSH term(s)	Echocardiography ; Echocardiography, Stress ; Humans ; Prognosis ; Referral and Consultation ; Ventricular Function, Left
Language	English
Publishing date	2019-06-06
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2435045-X
ISSN	1942-0080 ; 1941-9651
ISSN (online)	1942-0080
ISSN	1941-9651
DOI	10.1161/CIRCIMAGING.119.009318
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Article ; Online: Aberrant Neurofunctional Responses During Emotional and Attentional Processing Differentiate ADHD Youth With and Without a Family History of Bipolar I Disorder.

Patino, L Rodrigo / Wilson, Allison S / Tallman, Maxwell J / Blom, Thomas J / DelBello, Melissa P / McNamara, Robert K

Journal of attention disorders

2023 Volume 28, Issue 5, Page(s) 820–833

Abstract: Objective: To compare neurofunctional responses in emotional and attentional networks of psychostimulant-free ADHD youth with and without familial risk for bipolar I disorder (BD).: Methods: ADHD youth with (high-risk, HR, : Results: Compared with ...

Abstract	Objective: To compare neurofunctional responses in emotional and attentional networks of psychostimulant-free ADHD youth with and without familial risk for bipolar I disorder (BD). Methods: ADHD youth with (high-risk, HR, Results: Compared with HC, HR, but not LR, exhibited predominantly left-lateralized AMY, VLPFC, DLPFC, PCC, and rostral ACC hyperactivation to emotional distractors, whereas LR exhibited right VLPFC and bilateral dorsal ACC hypoactivation to attentional targets. Regional responses correlated with emotional and attention symptoms. Conclusion: Aberrant neurofunctional responses during emotional and attentional processing differentiate ADHD youth with and without a family history of BD and correlate with relevant symptoms ratings.
MeSH term(s)	Humans ; Adolescent ; Bipolar Disorder/psychology ; Attention Deficit Disorder with Hyperactivity/diagnosis ; Emotions/physiology ; Prefrontal Cortex ; Attention/physiology
Language	English
Publishing date	2023-12-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2004350-8
ISSN	1557-1246 ; 1087-0547
ISSN (online)	1557-1246
ISSN	1087-0547
DOI	10.1177/10870547231215292
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Zs.A 5196: Show issues

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Article ; Online: Factors associated with reporting left ventricular ejection fraction with 3D echocardiography in real-world practice.

Faridi, Kamil F / Zhu, Zhaohan / Shah, Nimish N / Crandall, Ian / McNamara, Robert L / Flueckiger, Peter / Bachand, Karen / Lombo, Bernardo / Hur, David J / Agarwal, Vratika / Reinhardt, Samuel W / Velazquez, Eric J / Sugeng, Lissa

Echocardiography (Mount Kisco, N.Y.)

2024 Volume 41, Issue 2, Page(s) e15774

Abstract: Background: Guidelines recommend 3D echocardiography (3DE) to assess left ventricular ejection fraction (LVEF) on transthoracic echocardiogram (TTE) when possible, but it is unclear which factors are most strongly associated with reporting 3DE LVEF in ... ...

Abstract	Background: Guidelines recommend 3D echocardiography (3DE) to assess left ventricular ejection fraction (LVEF) on transthoracic echocardiogram (TTE) when possible, but it is unclear which factors are most strongly associated with reporting 3DE LVEF in real-world practice. Methods: We evaluated 3DE LVEF reporting by age, sex, BMI, TTE location and variation in reporting by sonographer and reader. All TTEs were performed without contrast enhancement agent at a large medical center from 9/2015 to 12/2020 using ultrasound machines capable of 3DE. We used multivariable logistic regression to assess which factors were most associated with reporting 3DE LVEF. Results: Among 35 641 TTEs included in this study, 57.4% were performed on women. 3DE LVEF was reported on 18 391 TTEs (51.6% of cohort; 50.5% for women and 52.4% for men). Portable inpatient TTEs (n = 5569) had the lowest rates of 3DE LVEF reporting (30.9%), while general outpatient TTEs (n = 15 933) had greater reporting (56.9%). Outpatient TTEs with an indication for chemotherapy (n = 3244) had the highest rates of 3DE LVEF (87.2%). The median (IQR) percentage of TTEs reporting 3D LVEF was 52.7% (43.1%-68.1%) among sonographers and 51.6% (46.5%-59.6%) among readers. Among 20082 (56.3%) TTEs with 3DE LVEF measured by sonographers, 91.6% were included by readers in the final report. After adjustment, performing sonographer in the highest reporting quartile was most strongly associated with reporting 3DE LVEF (OR 7.04, 95% CI 6.55-7.56), while an inpatient portable study had the strongest negative association for reporting (OR .38, 95% CI .35-.40). Conclusions: Use of 3DE LVEF in real-world practice varies substantially based on performing sonographer and is low for hospitalized patients, but can be frequently used for chemotherapy. Initiatives are needed to increase sonographer 3DE acquisition in most clinical settings.
MeSH term(s)	Male ; Humans ; Female ; Ventricular Function, Left ; Stroke Volume ; Echocardiography, Three-Dimensional
Language	English
Publishing date	2024-02-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	843645-9
ISSN	1540-8175 ; 0742-2822
ISSN (online)	1540-8175
ISSN	0742-2822
DOI	10.1111/echo.15774
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Zs.A 2170: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Two- Versus 8-Zone Lung Ultrasound in Heart Failure: Analysis of a Large Data Set Using a Deep Learning Algorithm.

Baloescu, Cristiana / Chen, Alvin / Varasteh, Alexander / Toporek, Grzegorz / McNamara, Robert L / Raju, Balasundar / Moore, Chris

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

2023 Volume 42, Issue 10, Page(s) 2349–2356

Abstract: Objective: Scanning protocols for lung ultrasound often include 8 or more lung zones, which may limit real-world clinical use. We sought to compare a 2-zone, anterior-superior thoracic ultrasound protocol for B-line artifact detection with an 8-zone ... ...

Abstract	Objective: Scanning protocols for lung ultrasound often include 8 or more lung zones, which may limit real-world clinical use. We sought to compare a 2-zone, anterior-superior thoracic ultrasound protocol for B-line artifact detection with an 8-zone approach in patients with known or suspected heart failure using a deep learning (DL) algorithm. Methods: Adult patients with suspected heart failure and B-lines on initial lung ultrasound were enrolled in a prospective observational study. Subjects received daily ultrasounds with a hand-held ultrasound system using an 8-zone protocol (right and left anterior/lateral and superior/inferior). A previously published deep learning algorithm that rates severity of B-lines on a 0-4 scale was adapted for use on hand-held ultrasound full video loops. Average severities for 8 and 2 zones were calculated utilizing DL ratings. Bland-Altman plot analyses were used to assess agreement and identify bias between 2- and 8-zone scores for both primary (all patients, 5728 videos, 205 subjects) and subgroup (confirmed diagnosis of heart failure or pulmonary edema, 4464 videos, 147 subjects) analyses. Results: Bland-Altman plot analyses revealed excellent agreement for both primary and subgroup analyses. The absolute difference on the 4-point scale between 8- and 2-zone average scores was not significant for the primary dataset (0.03; 95% CI -0.01 to 0.07) or the subgroup (0.01; 95% CI -0.04 to 0.06). Conclusion: Utilization of a 2-zone, anterior-superior thoracic ultrasound protocol provided similar severity information to an 8-zone approach for a dataset of subjects with known or suspected heart failure.
MeSH term(s)	Adult ; Humans ; Deep Learning ; Lung/diagnostic imaging ; Heart Failure/diagnostic imaging ; Pulmonary Edema ; Ultrasonography/methods
Language	English
Publishing date	2023-05-31
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	604829-8
ISSN	1550-9613 ; 0278-4297
ISSN (online)	1550-9613
ISSN	0278-4297
DOI	10.1002/jum.16262
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Zs.A 1793: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 495: Show issues

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Article: Artificial intelligence-guided detection of under-recognized cardiomyopathies on point-of-care cardiac ultrasound.

Oikonomou, Evangelos K / Holste, Gregory / Coppi, Andreas / McNamara, Robert L / Nadkarni, Girish N / Baloescu, Cristiana / Krumholz, Harlan M / Wang, Zhangyang / Khera, Rohan

medRxiv : the preprint server for health sciences

2024

Abstract: Background: Point-of-care ultrasonography (POCUS) enables access to cardiac imaging directly at the bedside but is limited by brief acquisition, variation in acquisition quality, and lack of advanced protocols.: Objective: To develop and validate ... ...

Abstract	Background: Point-of-care ultrasonography (POCUS) enables access to cardiac imaging directly at the bedside but is limited by brief acquisition, variation in acquisition quality, and lack of advanced protocols. Objective: To develop and validate deep learning models for detecting underdiagnosed cardiomyopathies on cardiac POCUS, leveraging a novel acquisition quality-adapted modeling strategy. Methods: To develop the models, we identified transthoracic echocardiograms (TTEs) of patients across five hospitals in a large U.S. health system with transthyretin amyloid cardiomyopathy (ATTR-CM, confirmed by Tc Results: Our multi-label, view-agnostic classifier demonstrated state-of-the-art performance in discriminating ATTR-CM (AUROC 0.98 [95%CI: 0.96-0.99]) and HCM (AUROC 0.95 [95% CI: 0.94-0.96]) on standard TTE studies. Automated metrics of anatomical view correctness confirmed significantly lower quality in POCUS vs TTE videos (median view classifier confidence of 0.63 [IQR: 0.44-0.88] vs 0.93 [IQR: 0.69-1.00], Conclusions: We define and validate an AI framework that enables scalable, opportunistic screening of under-diagnosed cardiomyopathies using POCUS.
Language	English
Publishing date	2024-03-15
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.03.10.24304044
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Article: Study Protocol for the Artificial Intelligence-Driven Evaluation of Structural Heart Diseases Using Wearable Electrocardiogram (ID-SHD).

Aminorroaya, Arya / Dhingra, Lovedeep Singh / Camargos, Aline Pedroso / Shankar, Sumukh Vasisht / Khunte, Akshay / Sangha, Veer / McNamara, Robert L / Haynes, Norrisa / Oikonomou, Evangelos K / Khera, Rohan

medRxiv : the preprint server for health sciences

2024

Abstract: Introduction: Portable devices capable of electrocardiogram (ECG) acquisition have the potential to enhance structural heart disease (SHD) management by enabling early detection through artificial intelligence-ECG (AI-ECG) algorithms. However, the ... ...

Abstract	Introduction: Portable devices capable of electrocardiogram (ECG) acquisition have the potential to enhance structural heart disease (SHD) management by enabling early detection through artificial intelligence-ECG (AI-ECG) algorithms. However, the performance of these AI algorithms for identifying SHD in a real-world screening setting is unknown. To address this gap, we aim to evaluate the validity of our wearable-adapted AI algorithm, which has been previously developed and validated for detecting SHD from single-lead portable ECGs in patients undergoing routine echocardiograms in the Yale New Haven Hospital (YNHH). Research methods and analysis: This is the protocol for a cross-sectional study in the echocardiographic laboratories of YNHH. The study will enroll 585 patients referred for outpatient transthoracic echocardiogram (TTE) as part of their routine clinical care. Patients expressing interest in participating in the study will undergo a screening interview, followed by enrollment upon meeting eligibility criteria and providing informed consent. During their routine visit, patients will undergo a 1-lead ECG with two devices - one with an Apple Watch and the second with another portable 1-lead ECG device. With participant consent, these 1-lead ECG data will be linked to participant demographic and clinical data recorded in the YNHH electronic health records (EHR). The study will assess the performance of the AI-ECG algorithm in identifying SHD, including left ventricular systolic dysfunction (LVSD), valvular disease and severe left ventricular hypertrophy (LVH), by comparing the algorithm's results with data obtained from TTE, which is the established gold standard for diagnosing SHD. Ethics and dissemination: All patient EHR data required for assessing eligibility and conducting the AI-ECG will be accessed through secure servers approved for protected health information. Data will be maintained on secure, encrypted servers for a minimum of five years after the publication of our findings in a peer-reviewed journal, and any unanticipated adverse events or risks will be reported by the principal investigator to the Yale Institutional Review Board, which has reviewed and approved this protocol (Protocol Number: 2000035532).
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.03.18.24304477
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Article ; Online: Expansion of Neisseria meningitidis Serogroup C Clonal Complex 10217 during Meningitis Outbreak, Burkina Faso, 2019.

Kekeisen-Chen, Joann F / Tarbangdo, Felix T / Sharma, Shalabh / Marasini, Daya / Marjuki, Henju / Kibler, Janelle L / Reese, Heather E / Ouattara, Seydou / Ake, Flavien H / Yameogo, Issaka / Ouedraogo, Issa / Seini, Emmanuel / Zoma, Robert L / Tonde, Issa / Sanou, Mahamoudou / Novak, Ryan T / McNamara, Lucy A

Emerging infectious diseases

2024 Volume 30, Issue 3, Page(s) 460–468

Abstract: During January 28-May 5, 2019, a meningitis outbreak caused by Neisseria meningitidis serogroup C (NmC) occurred in Burkina Faso. Demographic and laboratory data for meningitis cases were collected through national case-based surveillance. Cerebrospinal ... ...

Abstract	During January 28-May 5, 2019, a meningitis outbreak caused by Neisseria meningitidis serogroup C (NmC) occurred in Burkina Faso. Demographic and laboratory data for meningitis cases were collected through national case-based surveillance. Cerebrospinal fluid was collected and tested by culture and real-time PCR. Among 301 suspected cases reported in 6 districts, N. meningitidis was the primary pathogen detected; 103 cases were serogroup C and 13 were serogroup X. Whole-genome sequencing revealed that 18 cerebrospinal fluid specimens tested positive for NmC sequence type (ST) 10217 within clonal complex 10217, an ST responsible for large epidemics in Niger and Nigeria. Expansion of NmC ST10217 into Burkina Faso, continued NmC outbreaks in the meningitis belt of Africa since 2019, and ongoing circulation of N. meningitidis serogroup X in the region underscore the urgent need to use multivalent conjugate vaccines in regional mass vaccination campaigns to reduce further spread of those serogroups.
MeSH term(s)	Humans ; Burkina Faso/epidemiology ; Serogroup ; Neisseria meningitidis, Serogroup C/genetics ; Disease Outbreaks ; Neisseria meningitidis/genetics ; Meningitis
Language	English
Publishing date	2024-02-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid3003.221760
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Article: Humoral correlates of protection against

Irvine, Edward B / Darrah, Patricia A / Wang, Shu / Wang, Chuangqi / McNamara, Ryan P / Roederer, Mario / Seder, Robert A / Lauffenburger, Douglas A / Flynn, JoAnne L / Fortune, Sarah M / Alter, Galit

bioRxiv : the preprint server for biology

2023

Abstract: Altering the route of Bacille Calmette-Guérin (BCG) immunization from low-dose intradermal vaccination to high-dose intravenous (IV) vaccination resulted in a high level of protection ... ...

Abstract	Altering the route of Bacille Calmette-Guérin (BCG) immunization from low-dose intradermal vaccination to high-dose intravenous (IV) vaccination resulted in a high level of protection against
Language	English
Publishing date	2023-08-02
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.07.31.551245
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Article: A Multimodality Video-Based AI Biomarker For Aortic Stenosis Development And Progression.

Oikonomou, Evangelos K / Holste, Gregory / Yuan, Neal / Coppi, Andreas / McNamara, Robert L / Haynes, Norrisa / Vora, Amit N / Velazquez, Eric J / Li, Fan / Menon, Venu / Kapadia, Samir R / Gill, Thomas M / Nadkarni, Girish N / Krumholz, Harlan M / Wang, Zhangyang / Ouyang, David / Khera, Rohan

medRxiv : the preprint server for health sciences

2024

Abstract: Importance: Aortic stenosis (AS) is a major public health challenge with a growing therapeutic landscape, but current biomarkers do not inform personalized screening and follow-up.: Objective: A video-based artificial intelligence (AI) biomarker ( ... ...

Abstract	Importance: Aortic stenosis (AS) is a major public health challenge with a growing therapeutic landscape, but current biomarkers do not inform personalized screening and follow-up. Objective: A video-based artificial intelligence (AI) biomarker (Digital AS Severity index [DASSi]) can detect severe AS using single-view long-axis echocardiography without Doppler. Here, we deploy DASSi to patients with no or mild/moderate AS at baseline to identify AS development and progression. Design setting and participants: We defined two cohorts of patients without severe AS undergoing echocardiography in the Yale-New Haven Health System (YNHHS) (2015-2021, 4.1[IQR:2.4-5.4] follow-up years) and Cedars-Sinai Medical Center (CSMC) (2018-2019, 3.4[IQR:2.8-3.9] follow-up years). We further developed a novel computational pipeline for the cross-modality translation of DASSi into cardiac magnetic resonance (CMR) imaging in the UK Biobank (2.5[IQR:1.6-3.9] follow-up years). Analyses were performed between August 2023-February 2024. Exposure: DASSi (range: 0-1) derived from AI applied to echocardiography and CMR videos. Main outcomes and measures: Annualized change in peak aortic valve velocity (AV-V Results: A total of 12,599 participants were included in the echocardiographic study (YNHHS: Conclusions and relevance: In this cohort study of patients without severe AS undergoing echocardiography or CMR imaging, a new AI-based video biomarker is independently associated with AS development and progression, enabling opportunistic risk stratification across cardiovascular imaging modalities as well as potential application on handheld devices.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.09.28.23296234
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