A knowledge graph-based analytical model for mining clinical value of drug stress echocardiography for diagnosis, risk stratification and prognostic evaluation of coronary artery disease.
A knowledge graph-based analytical model for mining clinical value of drug stress echocardiography for diagnosis, risk stratification and prognostic evaluation of coronary artery disease.
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基于知识图谱的分析模型，挖掘药物应激超声心动图对冠心病诊断、风险分层和预后评估的临床价值。
DOI：
10.1016/j.ijcard.2023.05.057
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发表时间：
2023
影响因子：
3.5
通讯作者：
Zhifeng Xiao
中科院分区：
文献类型：
--
作者：
Hongyi Wu;Zhifeng Xiao
临床上诊断冠心病包括心绞痛合并心肌缺血的主要技术有冠状动脉造影、心肌灌注成像和药物应激超声心动图。与前两种方法有创或使用放射性核素相比，药物应激超声心动图因其无创、低风险、可控、适用性广等优点，越来越多地应用于临床。我们开发了一种新的方法来证明基于知识图的药物应激超声心动图疗效分析，作为传统荟萃分析的补充。通过测量冠状动脉血流储备（CFR），我们发现局部心室壁异常（RVWA）和载药心脏超声可用于检测冠状动脉疾病。此外，载药心脏超声可用于识别心脏缺血区域，分层风险，并确定预后。此外，腺苷应激超声心动图（ASE）可以通过CFR和相关定量指标进行危险分层，确定冠心病不典型症状并伴有心脏事件。使用基于知识图的方法，我们调查了三种药物——双嘧达莫、多巴酚丁胺和腺苷——对冠状动脉疾病分析的正面和负面影响。我们的研究结果表明，腺苷在三种药物中具有最高的积极作用和最低的消极作用。由于其副作用小且可控，对诊断冠状动脉微循环障碍和多发病变具有较高的敏感性，腺苷在临床中被频繁使用。
The three major techniques for clinically diagnosing coronary heart disease, including angina associated with myocardial ischemia, are coronary angiography, myocardial perfusion imaging, and drug stress echocardiography. Compared to the first two methods, which are invasive or involve the use of radionuclides, drug stress echocardiography is increasingly used in clinical practice due to its non-invasive, low-risk, and controllable nature, and wide applicability. We developed a novel methodology to demonstrate knowledge graph-based efficacy analysis of drug stress echocardiography as a complement to traditional meta-analysis. By measuring coronary flow reserve (CFR), we discovered that regional ventricular wall abnormalities (RVWA) and drug-loaded cardiac ultrasound can be used to detect coronary artery disease. Additionally, drug-loaded cardiac ultrasound can be used to identify areas of cardiac ischemia, stratify risks, and determine prognosis. Furthermore, adenosine stress echocardiography(ASE) can determine atypical symptoms of coronary heart disease with associated cardiac events through CFR and related quantitative indices for risk stratification. Using a knowledge graph-based approach, we investigated the positive and negative effects of three drugs - Dipyridamole, Dobutamine, and Adenosine - for coronary artery disease analysis. Our findings show that Adenosine has the highest positive effect and the lowest negative effect among the three drugs. Due to its minimal and controlled side effects, and high sensitivity for diagnosing coronary microcirculation disorders and multiple lesions, adenosine is frequently used in clinical practice.
影响因子：
3.5
作者：
Shah AS;Lampert R;Goldberg J;Bremner JD;Li L;Thames MD;Vaccarino V;Shah AJ
通讯作者：
Shah AJ
影响因子：
24
作者：
Pepine, Carl J.;Anderson, David;Sharaf, Barry L.;Reis, Steven E.;Smith, Karen M.;Handberg, Eileen M.;Johnson, B. Delia;Sopko, George;Merz, Noel Bairey
通讯作者：
Merz, Noel Bairey