2024
Artificial intelligence applied to electrocardiographic images for scalable screening of cardiac amyloidosis
Sangha V, Oikonomou E, Krumholz H, Miller E, Khera R. Artificial intelligence applied to electrocardiographic images for scalable screening of cardiac amyloidosis. European Heart Journal 2024, 45: ehae666.3436. DOI: 10.1093/eurheartj/ehae666.3436.Peer-Reviewed Original ResearchATTR-CMBone scintigraphy scansTransthyretin amyloid cardiomyopathyPositive predictive valueAI-ECG algorithmCardiac amyloidosisScintigraphy scanAmyloid cardiomyopathyAI-ECGSex-matchedDevelopment cohortMyocardial remodelingUnder-diagnosedUnder-treatedMatched controlsPredictive valueUnder-recognizedTransthyretin stabilizersConvolutional neural networkPatientsECGArtificial intelligenceHospitalPrevalenceTransthyretinReproducibility for quantification of myocardial Tc-99m PYP amyloid uptake in grade 1 patients
Sandoval V, Goyal D, Miller E, Liu Y. Reproducibility for quantification of myocardial Tc-99m PYP amyloid uptake in grade 1 patients. European Heart Journal - Cardiovascular Imaging 2024, 25: jeae142.047. DOI: 10.1093/ehjci/jeae142.047.Peer-Reviewed Original ResearchStandardized uptake valueTc-99m PYP uptakeTc-99Cardiac amyloidosisHeart failureStandard uptake value quantificationStandardized uptake value calculationSPECT imagesIntractable heart failureSystolic heart failureIntroduction of therapyPlanar imagingTc-99m pyrophosphateAmyloid patientsSPECT/CT imagingInter-reproducibilityUptake valueContralateral ratioCoefficient of variationDisease progressionH/M ratioGrade 1Blood poolPatientsH/CL ratioImpact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography
Randazzo M, Elias P, Poterucha T, Sharir T, Fish M, Ruddy T, Kaufmann P, Sinusas A, Miller E, Bateman T, Dorbala S, Di Carli M, Castillo M, Liang J, Miller R, Dey D, Berman D, Slomka P, Einstein A. Impact of cardiac size on diagnostic performance of single-photon emission computed tomography myocardial perfusion imaging: insights from the REgistry of Fast Myocardial Perfusion Imaging with NExt generation single-photon emission computed tomography. European Heart Journal - Cardiovascular Imaging 2024, 25: 996-1006. PMID: 38445511, PMCID: PMC11210974, DOI: 10.1093/ehjci/jeae055.Peer-Reviewed Original ResearchSPECT myocardial perfusion imagingMyocardial perfusion imagingCoronary artery diseaseCardiac sizeDetect obstructive coronary artery diseasePerfusion imagingObstructive coronary artery diseaseDetection of coronary artery diseaseNegative predictive valueLeft ventricular volumeSolid-state scannersSmall cardiac sizeCoronary angiographyMale patientsYounger patientsElderly patientsMale sexDiagnostic performanceVentricular volumeArtery diseaseVisual assessmentPatientsPredictive valueElderly ageSPECT
2023
Clinical Penetrance of the Transthyretin V122I Variant in Older Black Patients With Heart Failure: The SCAN‐MP (Screening for Cardiac Amyloidosis With Nuclear Imaging in Minority Populations) Study
Madhani A, Sabogal N, Massillon D, Paul L, Rodriguez C, Fine D, Helmke S, Winburn M, Kurian D, Raiszadeh F, Teruya S, Cohn E, Einstein A, Miller E, Connors L, Maurer M, Ruberg F. Clinical Penetrance of the Transthyretin V122I Variant in Older Black Patients With Heart Failure: The SCAN‐MP (Screening for Cardiac Amyloidosis With Nuclear Imaging in Minority Populations) Study. Journal Of The American Heart Association 2023, 12: e028973. PMID: 37486082, PMCID: PMC10492994, DOI: 10.1161/jaha.122.028973.Peer-Reviewed Original ResearchConceptsATTR-CMHeart failurePrealbumin concentrationsLeft ventricular wall thicknessPhenotypic penetranceHereditary ATTR-CMOlder black patientsAdvanced heart failureV122I variantVentricular wall thicknessProspective multisite studyYears of ageBlack individualsPyrophosphate imagingEchocardiographic parametersUnderdiagnosed causeBlack patientsSelf-identified Black individualsHF controlsClinical penetrancePrevalenceHispanic individualsMultisite studyBlack participantsPatientsVessel Distribution Of Coronary Artery Calcium From Gated CT And Low-dose Ungated CT Imaging Does Not Improve The Prediction Of MACE In Patients Referred For SPECT
Zhou J, Shanbhag A, Bednarski B, Huang C, Miller R, Han D, Pieszko K, Lemley M, Bateman T, Miller E, Dey D, Berman D, Slomka P. Vessel Distribution Of Coronary Artery Calcium From Gated CT And Low-dose Ungated CT Imaging Does Not Improve The Prediction Of MACE In Patients Referred For SPECT. Journal Of Cardiovascular Computed Tomography 2023, 17: s47-s48. DOI: 10.1016/j.jcct.2023.05.119.Peer-Reviewed Original ResearchTime and event-specific deep learning for personalized risk assessment after cardiac perfusion imaging
Pieszko K, Shanbhag A, Singh A, Hauser M, Miller R, Liang J, Motwani M, Kwieciński J, Sharir T, Einstein A, Fish M, Ruddy T, Kaufmann P, Sinusas A, Miller E, Bateman T, Dorbala S, Di Carli M, Berman D, Dey D, Slomka P. Time and event-specific deep learning for personalized risk assessment after cardiac perfusion imaging. Npj Digital Medicine 2023, 6: 78. PMID: 37127660, PMCID: PMC10151323, DOI: 10.1038/s41746-023-00806-x.Peer-Reviewed Original ResearchAcute coronary syndromeMajor adverse cardiovascular eventsMyocardial perfusion imagingCause deathAdverse cardiovascular eventsModifiable risk factorsPrediction of deathPersonalized risk assessmentCardiovascular eventsCoronary syndromeClinical featuresPrognostic valueRisk factorsExternal cohortStandard clinical interpretationPerfusion imagingAbnormality measuresCardiac perfusionTime pointsPatients' explanationsClinical interpretationExternal validationDeathPatientsRisk assessmentUnsupervised learning to characterize patients with known coronary artery disease undergoing myocardial perfusion imaging
Williams M, Bednarski B, Pieszko K, Miller R, Kwiecinski J, Shanbhag A, Liang J, Huang C, Sharir T, Dorbala S, Di Carli M, Einstein A, Sinusas A, Miller E, Bateman T, Fish M, Ruddy T, Acampa W, Hauser M, Kaufmann P, Dey D, Berman D, Slomka P. Unsupervised learning to characterize patients with known coronary artery disease undergoing myocardial perfusion imaging. European Journal Of Nuclear Medicine And Molecular Imaging 2023, 50: 2656-2668. PMID: 37067586, PMCID: PMC10317876, DOI: 10.1007/s00259-023-06218-z.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseMyocardial perfusion imagingCause mortalityTotal perfusion deficitArtery diseaseRisk stratificationPerfusion deficitsHigher body mass indexTomography myocardial perfusion imagingMore diabetes mellitusSPECT myocardial perfusion imagingBetter risk stratificationRisk-stratify patientsBody mass indexREFINE SPECT registrySingle photon emissionDiabetes mellitusMass indexExternal cohortStress imagingMyocardial perfusionPatientsRisk phenotypePerfusion imagingImaging characteristicsDesign and Rationale the SCAN‐MP (Screening for Cardiac Amyloidosis With Nuclear Imaging in Minority Populations) Study
Ruberg F, Blaner W, Chiuzan C, Connors L, Einstein A, Fine D, Helmke S, Kurian D, Pandey S, Raiszadeh F, Rodriguez C, Sabogal N, Teruya S, Winburn M, Chung W, Cohn E, Miller E, Kelly J, Maurer M. Design and Rationale the SCAN‐MP (Screening for Cardiac Amyloidosis With Nuclear Imaging in Minority Populations) Study. Journal Of The American Heart Association 2023, 12: e028534. PMID: 37066788, PMCID: PMC10227254, DOI: 10.1161/jaha.122.028534.Peer-Reviewed Original ResearchConceptsATTR-CMHeart failureHealth/National HeartOlder black patientsYears of ageCaribbean Hispanic patientsDeposition of transthyretinNoninvasive nuclear imagingBlack patientsHispanic patientsProspective studyBlood InstituteSelf-identified Black individualsNational HeartCardiac amyloidosisUS FoodImportant causeSecondary objectiveOlder individualsSubstitution of valineHispanic individualsNuclear imagingNational InstituteBlack individualsPatientsAutoimmune comorbidities associated with sarcoidosis: a case-control study in the All of Us research program
Murphy M, Edemobi P, Leasure A, Gulati M, Miller E, Damsky W, Cohen J. Autoimmune comorbidities associated with sarcoidosis: a case-control study in the All of Us research program. Rheumatology Advances In Practice 2023, 7: rkad030. PMID: 38606002, PMCID: PMC11007907, DOI: 10.1093/rap/rkad030.Peer-Reviewed Original ResearchCase-control studyAutoimmune diseasesSarcoidosis patientsMultivariable analysisOdds ratioSarcoidosis casesUs Research ProgramDiverse cohortConcomitant autoimmune diseasesRace-matched controlsMultiple autoimmune diseasesAutoimmune comorbiditiesSarcoidosisPatientsLogistic regressionDiseaseSmall sample sizeCareful screeningCohortAssociationSample sizeComposite variablePrior studiesComorbiditiesStudyCorrection to: Integration of coronary artery calcium scoring from CT attenuation scans by machine learning improves prediction of adverse cardiovascular events in patients undergoing SPECT/CT myocardial perfusion imaging
Feher A, Pieszko K, Miller R, Lemley M, Shanbhag A, Huang C, Miras L, Liu Y, Sinusas A, Miller E, Slomka P. Correction to: Integration of coronary artery calcium scoring from CT attenuation scans by machine learning improves prediction of adverse cardiovascular events in patients undergoing SPECT/CT myocardial perfusion imaging. Journal Of Nuclear Cardiology 2023, 30: 860-863. PMID: 36598750, DOI: 10.1007/s12350-022-03196-x.Peer-Reviewed Original ResearchCORONARY ARTERY CALCIFICATIONS ARE A BETTER PREDICTOR OF CARDIOVASCULAR OUTCOMES THAN ISCHEMIC ECG CHANGES IN PATIENTS WITH NORMAL PERFUSION ON EXERCISE SPECT
Shi T, Kokkinidis D, Agarwal R, Liu Y, Sinusas A, Miller E, Feher A. CORONARY ARTERY CALCIFICATIONS ARE A BETTER PREDICTOR OF CARDIOVASCULAR OUTCOMES THAN ISCHEMIC ECG CHANGES IN PATIENTS WITH NORMAL PERFUSION ON EXERCISE SPECT. Journal Of The American College Of Cardiology 2023, 81: 1498. DOI: 10.1016/s0735-1097(23)01942-3.Peer-Reviewed Original ResearchIN PATIENTS UNDERGOING NUCLEAR MYOCARDIAL PERFUSION IMAGING, RHEUMATOID ARTHRITIS IS ASSOCIATED WITH INCREASED RISK OF ADVERSE CARDIOVASCULAR EVENTS INDEPENDENT OF MYOCARDIAL ISCHEMIA
Pires J, Oikonomou E, Agarwal R, Liu Y, miller E, Sinusas A, Feher A. IN PATIENTS UNDERGOING NUCLEAR MYOCARDIAL PERFUSION IMAGING, RHEUMATOID ARTHRITIS IS ASSOCIATED WITH INCREASED RISK OF ADVERSE CARDIOVASCULAR EVENTS INDEPENDENT OF MYOCARDIAL ISCHEMIA. Journal Of The American College Of Cardiology 2023, 81: 1467. DOI: 10.1016/s0735-1097(23)01911-3.Peer-Reviewed Original ResearchDiagnostic performance characteristics of planar quantitative and semi-quantitative parameters of Tc99m pyrophosphate (PYP) imaging for diagnosis of transthyretin (ATTR) cardiac amyloidosis: the SCAN-MP study
Pandey S, Teruya S, Rodriguez C, Deluca A, Kinkhabwala M, Johnson L, Fine D, Sabogal N, Winburn M, Castillo M, Bhatia K, Malkovskaya R, Raiszadeh F, Kurian D, Miller E, Einstein A, Maurer M, Ruberg F. Diagnostic performance characteristics of planar quantitative and semi-quantitative parameters of Tc99m pyrophosphate (PYP) imaging for diagnosis of transthyretin (ATTR) cardiac amyloidosis: the SCAN-MP study. Journal Of Nuclear Cardiology 2023, 30: 1414-1419. PMID: 36823486, PMCID: PMC11268194, DOI: 10.1007/s12350-023-03203-9.Peer-Reviewed Original ResearchConceptsTransthyretin cardiac amyloidosisATTR-CACardiac amyloidosisLow pretest probabilityLow pretest likelihoodLV wall thicknessDiagnostic performance characteristicsPositive predictive valueNon-invasive diagnosisConclusionAmong patientsMinority older adultsHeart failurePretest likelihoodPretest probabilitySemi-quantitative parametersPYP uptakeImportant misclassificationPredictive valueImaging thresholdsOptimal heartOlder adultsDiagnostic performancePatientsReference standardScans
2022
Mitigating bias in deep learning for diagnosis of coronary artery disease from myocardial perfusion SPECT images
Miller RJH, Singh A, Otaki Y, Tamarappoo BK, Kavanagh P, Parekh T, Hu LH, Gransar H, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli MF, Liang JX, Dey D, Berman DS, Slomka PJ. Mitigating bias in deep learning for diagnosis of coronary artery disease from myocardial perfusion SPECT images. European Journal Of Nuclear Medicine And Molecular Imaging 2022, 50: 387-397. PMID: 36194270, PMCID: PMC10042590, DOI: 10.1007/s00259-022-05972-w.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseMyocardial perfusion imagingArtery diseaseInvasive angiographyObstructive coronary artery diseaseDisease probabilityLow-risk patientsLow-risk populationHigh-risk populationTotal perfusion deficitHigh diagnostic accuracyS-TPDPerfusion deficitsPatient managementPatientsPerfusion imagingDiagnostic accuracyPerfusion SPECT imagesLower likelihoodGood calibrationCharacteristic curveAngiographySPECT imagesSelection biasDiseaseMachine learning to predict abnormal myocardial perfusion from pre-test features
Miller RJH, Hauser MT, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Huang C, Liang JX, Han D, Dey D, Berman DS, Slomka PJ. Machine learning to predict abnormal myocardial perfusion from pre-test features. Journal Of Nuclear Cardiology 2022, 29: 2393-2403. PMID: 35672567, PMCID: PMC9588501, DOI: 10.1007/s12350-022-03012-6.Peer-Reviewed Original ResearchConceptsAbnormal myocardial perfusionAbnormal perfusionMyocardial perfusionDiamond-Forrester modelCAD consortiumConsecutive patientsInternational registryPre-test informationSPECT-MPIClinical informationPhysician's decisionPatientsPerfusionTesting populationExpert visual interpretationRegistryPopulationMethodsWePhysiciansCharacteristics of patients referred to a cardiovascular disease clinic for post-acute sequelae of SARS-CoV-2 infection
Wang SY, Adejumo P, See C, Onuma OK, Miller EJ, Spatz ES. Characteristics of patients referred to a cardiovascular disease clinic for post-acute sequelae of SARS-CoV-2 infection. American Heart Journal Plus Cardiology Research And Practice 2022, 18: 100176. PMID: 35856065, PMCID: PMC9277988, DOI: 10.1016/j.ahjo.2022.100176.Peer-Reviewed Original ResearchSARS-CoV-2 infectionCardiovascular disease clinicPost-acute sequelaeDisease clinicCommon symptomsExercise intoleranceChest pain/pressureNew cardiac diagnosesNew cardiovascular diseaseCharacteristics of patientsPain/pressurePattern of symptomsCOVID-19 diagnosisCardiovascular manifestationsCardiovascular symptomsCardiovascular diseaseDiagnostic evaluationObservational studyAverage agePatientsCardiac diagnosisCardiac pathologyCardiovascular diagnosisSymptomsDiagnosisExplainable Deep Learning Improves Physician Interpretation of Myocardial Perfusion Imaging.
Miller RJH, Kuronuma K, Singh A, Otaki Y, Hayes S, Chareonthaitawee P, Kavanagh P, Parekh T, Tamarappoo BK, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Carli MD, Cadet S, Liang JX, Dey D, Berman DS, Slomka PJ. Explainable Deep Learning Improves Physician Interpretation of Myocardial Perfusion Imaging. Journal Of Nuclear Medicine 2022, 63: 1768-1774. PMID: 35512997, PMCID: PMC9635672, DOI: 10.2967/jnumed.121.263686.Peer-Reviewed Original ResearchConceptsMyocardial perfusion imagingCoronary artery diseaseObstructive coronary artery diseasePhysician interpretationDiagnostic accuracyPerfusion imagingLeft main arteryOverall net reclassification improvementInvasive coronary angiographyNet reclassification improvementTotal perfusion deficitArtery diseaseCoronary angiographyMedian agePhysician diagnosisReclassification improvementPerfusion deficitsClinical historyCoronary segmentsRepresentative cohortMeaningful improvementsMain arteryPatientsDL resultsQuantitative perfusionPrevalence and predictors of automatically quantified myocardial ischemia within a multicenter international registry
Han D, Rozanski A, Miller RJH, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Liang JX, Dey D, Berman DS, Slomka PJ. Prevalence and predictors of automatically quantified myocardial ischemia within a multicenter international registry. Journal Of Nuclear Cardiology 2022, 29: 3221-3232. PMID: 35174442, PMCID: PMC9378748, DOI: 10.1007/s12350-021-02829-x.Peer-Reviewed Original ResearchConceptsTotal perfusion deficitMyocardial ischemiaStress testingCAD risk factorsMulticenter international registryPredictor of ischemiaCardiac stress testingNuclear stress testingChi-square testConclusionThe prevalenceMulticenter registryOverall cohortTypical anginaCAD statusPerfusion deficitsInternational registryMale genderRisk factorsLVEFIschemiaPatientsImaging characteristicsPotent predictorPrevalenceRegistry
2021
Comparison of diabetes to other prognostic predictors among patients referred for cardiac stress testing: A contemporary analysis from the REFINE SPECT Registry
Han D, Rozanski A, Gransar H, Tzolos E, Miller RJH, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Liang JX, Hu LH, Dey D, Berman DS, Slomka PJ. Comparison of diabetes to other prognostic predictors among patients referred for cardiac stress testing: A contemporary analysis from the REFINE SPECT Registry. Journal Of Nuclear Cardiology 2021, 29: 3003-3014. PMID: 34757571, PMCID: PMC9085969, DOI: 10.1007/s12350-021-02810-8.Peer-Reviewed Original ResearchConceptsMajor adverse cardiovascular eventsCoronary artery diseaseTotal perfusion deficitCardiac stress testingStress testingComparison of diabetesAdverse cardiovascular eventsStress test patientsCardiac stress test patientsREFINE SPECT registryDM statusMACE riskBackgroundDiabetes mellitusCardiovascular eventsArtery diseaseVentricular functionPrognostic predictorClinical variablesPerfusion deficitsChi-square analysisSPECT-MPIPatientsTest patientsPropensity scorePotent predictorClinical Deployment of Explainable Artificial Intelligence of SPECT for Diagnosis of Coronary Artery Disease
Otaki Y, Singh A, Kavanagh P, Miller RJH, Parekh T, Tamarappoo BK, Sharir T, Einstein AJ, Fish MB, Ruddy TD, Kaufmann PA, Sinusas AJ, Miller EJ, Bateman TM, Dorbala S, Di Carli M, Cadet S, Liang JX, Dey D, Berman DS, Slomka PJ. Clinical Deployment of Explainable Artificial Intelligence of SPECT for Diagnosis of Coronary Artery Disease. JACC Cardiovascular Imaging 2021, 15: 1091-1102. PMID: 34274267, PMCID: PMC9020794, DOI: 10.1016/j.jcmg.2021.04.030.Peer-Reviewed Original ResearchConceptsTotal perfusion deficitMyocardial perfusion imagingStandard clinical softwareStress total perfusion deficitObstructive CADTomography myocardial perfusion imagingSPECT myocardial perfusion imagingStress myocardial perfusionCoronary artery diseaseReceiver-operating characteristic curveInvasive coronary angiographyClinical softwareReader diagnosisSingle photon emissionTypical clinical workflowArtery diseaseCoronary angiographyPerfusion deficitsDiagnostic findingsMyocardial perfusionPerfusion imagingVentricular volumeStandard clinical workstationPatientsDiagnostic accuracy