Articles of Interest: Hydrogels, Flu Shots, and AI for Prescreening of Heart Failure

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Abstract image of an artificial neural network creating a heart

This week we look at how a new hydrogel promises to help repair dynamic tissue, why flu vaccines benefit cardiovascular (CV) patients, and how artificial intelligence (AI) systems can assist in prescreening for heart failure with preserved ejection fraction (HFpEF).

A New Hydrogel Shows Promise for Repairing Dynamic Tissues

Hydrogels are highly absorbent, synthetic polymers that can maintain a well-defined structure. Because they are biodegradable, biocompatible, and antitoxic, injectable hydrogels could be used to promote tissue repair. However, hydrogels cannot withstand the mechanical demands of frequently moving tissues like heart muscle and vocal folds and have a short lifetime when injected into these tissues. Teheri et al, researchers from McGill University, recently published a manuscript in Advanced Science describing a new methodology to give injectable hydrogels superior permeability, toughness and biocompatibility, all necessary qualities for these materials to be successfully used for repair and regeneration of dynamic, moving tissues. Advances like this could have a significant impact on tissue repair and engineering and drug delivery. Hopefully, one day this technology can help restore function to damaged tissues and improve outcomes for patients.

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The Flu Shot Improves Outcomes for People with Cardiovascular Disease

"Getting a flu shot this year is even more important as seasonal flu activity will coincide with the ongoing COVID-19 pandemic, posing a double threat to people at high risk of complications."

We are in the middle of the flu season and, while we have all been focused on COVID vaccines, it is important to remember that the vaccination for influenza, i.e., the flu shot, is important for people with cardiovascular disease (CVD). The American College of Cardiology (ACC) has published educational material to help CV specialists encourage their patients to get the flu shot every year. People with CVD are ten times more likely to have a heart attack within three days of contracting the flu and that risk continues for weeks after the flu is gone. On the other hand, getting an annual flu shot decreases the risk of major adverse cardiac events (MACE) by 36% and lowers CVD-related hospitalization by 22% for patients with heart failure.

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"Flu vaccination should be a routine part of any conversation with patients about measures to reduce their cardiac risk, just like they take their heart medicines, exercise and are mindful of what they eat."

Using AI Assistance to Prescreen for HFpEF

Heart failure (HF) can either 1) decrease the systolic function of the left ventricle (LV), resulting in a reduced ejection fraction (EF), or 2) cause diastolic dysfunction, while preserving the ejection fraction (HFpEF). Diagnosing HFpEF with echocardiography is a complex task requiring a significant amount of time and clinical expertise. In a recent JACC: Cardiovascular Imaging article, Chiou et al trained a convolutional neural network (CNN) to provide rapid and accurate prescreening of HFpEF.

"Our AI model can be a reliable prescreening tool compared with the time-consuming conventional HFpEF diagnosis process; moreover, it can provide quantitative information to assist inexperienced observers in the diagnosis HFpEF."

This model incorporated the variability of left ventricular and left atrial length, width, area, and volume between heartbeats, or “intrabeat dynamics”. These features had more predictive value for HFpEF than other parameters, resulting in impressive predictive accuracy with an AUC of 0.93 when validated on an external dataset. This is an excellent example of how AI can assist physicians in identifying patients that likely have HFpEF, providing time-savings and decreasing the workload of clinical experts.

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