HeartModel^A.I. Assessment Of Left Ventricular Function In Patients With Coronary Atherosclerotic Heart Disease Complicated With Ischemic Mitral Regurgitation

Objective:Conduct a quantitative evaluation on the left ventricular chamber in patients with Coronary atherosclerotic heart disease and ischemic mitral regurgitation using a novel intelligent cardiac three-dimensional quantitative tool(Heart Model ^A.I.,referred to as HM)based on a human cardiac anatomical structure data model,and to analyse its feasibility,clinical value and related influencing factors It provides valuable suggestions on the evaluation of the severity of illness and the efficacy and prognosis of surgery and on the development of appropriate surgical strategies.Methods:A prospective study was conducted to evaluate left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）,left ventricular ejection fraction（LVEF）and mitral regurgitation（MRV）in patients with coronary heart disease complicated with ischemic mitral valve disease using HM tool,and other traditional echocardiographic methods were used at the same time:biplane Simpson method based on two-dimensional echocardiography（2DE）;traditional manual quantitative 3DQ software based on three-dimensional echocardiography（3DE）;proximal isokinetic surface area method（PISA）under 2DE was used for measure value regurgitation,and the results were compared with cardiac magnetic resonance（CMR）to investigate the influencing factors.Results:There were significant differences in LVEF,LVEDV,and LVESV between HM,2DE,and CMR（P<0.05）;there was no significant difference in LVEF between 3DE and CMR（P>0.05）,but there were significant differences between LVEDV and LVESV with CMR（P<0.05）;HM,2DE,and 3DE were lower than CMR,but HM were closer to CMR.HM had the highest sensitivity（65.2%）and specificity（50.0%）in identifying LVEF>35%.HM,2DE,and 3DE were positively correlated with LVEF,LVEDV,and LVESV measured by CMR,with HM having the best correlation with CMR（r=0.734,0.889,0.931）.The consistency between HM,2DE,3DE and CMR measurements was good.Repeatability analysis of HM,2DE,and 3DE measurements showed that HM had the highest reproducibility,with all intraclass correlation coefficients>0.9.There was no significant difference inΔLVEF andΔLVEDV between patients with myocardial infarction,ventricular aneurysm,LVEF>35%and different image quality（P>0.05）;there was significant difference inΔLVESV between patients with myocardial infarction and LVEF greater than 35%（P<0.05）,but there was no significant difference between patients with ventricular aneurysm and different image quality（P>0.05）.The MRV measured by HM was slightly higher than that measured by CMR,and the difference between the two methods was not statistically significant（P>0.05）,and the MRV measured by PISA method under two-dimensional echocardiography was lower than that measured by CMR,and the difference between them was statistically significant（P<0.05）.There was a low correlation between MRV measured by HM and CMR（r=0.457,P<0.05）,and there was no linear correlation between MRV measured by PISA method and CMR（r=0.091,P>0.05）.There was good consistency between HM,PISA and CMR in measuring MRV.Conclusions:HM software has a good correlation and consistency with CMR in evaluating and analyzing left ventricular function and MRV in patients with coronary heart disease complicated with ischemic mitral regurgitation,and the accuracy and repeatability are superior to traditional 2DE and semi-automatic 3DE.Myocardial infarction and decreased LVEF are the influencing factors that lead to the deviation of HM measurement.