著者

Kenta Yamada Yudai Tamura Hirohisa Taniguchi Asuka Furukawa Jin Iwasawa Hirotaka Yada Akio Kawamura Yuichi Tamura

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.4, no.11, pp.526-532, 2022-11-10 (Released:2022-11-10)

参考文献数

12

被引用文献数

1

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Background: Trastuzumab, an anti-human epidermal growth factor receptor 2 (HER2) monoclonal antibody, is a specific first-line treatment for patients with HER2-positive cancers. Cardiac dysfunction is among the most problematic adverse events associated with trastuzumab. Although regular echocardiographic screening is recommended for early detection of cardiac damage, few reports have investigated the validity of echocardiographic screening in chemotherapy. Therefore, the aim of this study was to determine whether a GLS-guided management approach could reduce cardiotoxicity and discontinuation of trastuzumab chemotherapy.Methods and Results: To evaluate the usefulness of global longitudinal strain (GLS)-guided cardioprotective interventions, we retrospectively analyzed 67 patients treated with trastuzumab who underwent structured echocardiographic assessments before and after 1, 3, and 6 courses of trastuzumab administration. If a >15% relative decrease in GLS was identified, cardioprotective agents were administered. Thirty (44.8%) patients had breast cancer; the remaining patients had salivary gland cancer. The median observation period for the intervention group was 304 days from the initial evaluation. Nineteen (28.4%) patients exhibited a >15% relative decrease in GLS, and consequently received cardioprotective agents. The incidence of trastuzumab discontinuation for cardiogenic reasons was significantly lower among patients receiving GLS-guided interventions than among those not receiving the intervention (2.4% vs. 24.0%; P=0.009). The incidence of a subsequent decline in left ventricular ejection fraction was lower among patients receiving the intervention than among those not receiving the intervention (4.8% vs. 24.0%; P=0.04).Conclusions: GLS-guided cardioprotective intervention significantly decreased the incidence of trastuzumab discontinuation.

著者

Hirohisa Taniguchi Tomohiro Takata Mineki Takechi Asuka Furukawa Jin Iwasawa Akio Kawamura Tadahiro Taniguchi Yuichi Tamura

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.62, no.3, pp.534-539, 2021-05-29 (Released:2021-05-29)

参考文献数

22

被引用文献数

19

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Atrial fibrillation is a clinically important arrhythmia. There are some reports on machine learning models for AF diagnosis using electrocardiogram data. However, few reports have proposed an eXplainable Artificial Intelligence (XAI) model to enable physicians to easily understand the machine learning model's diagnosis results.We developed and validated an XAI-enabled atrial fibrillation diagnosis model based on a convolutional neural network (CNN) algorithm. We used Holter electrocardiogram monitoring data and the gradient-weighted class activation mapping (Grad-CAM) method.Electrocardiogram data recorded from patients between January 4, 2016, and October 31, 2019, totaling 57,273 electrocardiogram waveform slots of 30 seconds each with diagnostic information annotated by cardiologists, were used for training our proposed model. Performance metrics of our AI model for AF diagnosis are as follows: sensitivity, 97.1% (95% CI: 0.969-0.972); specificity, 94.5% (95% CI: 0.943-0.946); accuracy, 95.3% (95% CI: 0.952-0.955); positive predictive value, 89.3% (95% CI: 0.892-0.897); and F-value, 93.1% (95% CI: 0.929-0.933). The area under the receiver operating characteristic curve for AF detection using our model was 0.988 (95% CI: 0.987-0.988). Furthermore, using the XAI method, 94.5 ± 3.5% of the areas identified as regions of interest using our machine learning model were identified as characteristic sites for AF diagnosis by cardiologists.AF was accurately diagnosed and favorably explained with Holter ECG waveforms using our proposed CNN-based XAI model. Our study presents another step toward realizing a viable XAI-based detection model for AF diagnoses for use by physicians.

著者

Yuichi Tamura Rika Takeyasu Asuka Furukawa Hiromi Takada Mineki Takechi Hirohisa Taniguchi Akio Kawamura

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.9, pp.526-530, 2020-09-10 (Released:2020-09-10)

参考文献数

15

被引用文献数

6

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Background:COVID-19 is fatal to patients with pulmonary hypertension (PH), so preventive actions are recommended. This study investigated the effectiveness of telemedicine and effects on quality of life (QOL) in the treatment of patients with PH.Methods and Results:Japanese patients with PH (n=40) were recruited from one referral center. Patient self-reported anxiety worsened significantly and elderly patients in particular experienced detrimental lifestyle changes under COVID-19. Telemedicine worked well to decrease the frequency of going out.Conclusions:Telemedicine is effective in reducing travel distances, and frequent remote interventions may be desirable for older, anxious patients.