ACC.18 Research Highlights Technology in CV Care, CV Risk in Football Players, Flu Vaccine in HF

Several consumer studies exploring new technology applications in cardiovascular care, potential cardiovascular risk for football players, and whether the influenza vaccine affects the risk of mortality in heart failure (HF) patients will be presented at ACC.18 in Orlando.

Technology in CV Care

In one study, Daniel Lindholm, MD, PhD, et al., used machine learning to predict myocardial infarction (MI) diagnosis from more than 8,200 emergency department visits. In the first phase, the algorithm used data from 5,800 visits to iteratively refine decision trees to identify a MI diagnosis based on factors such as blood test results, vital signs and medical history. For the second phase, the algorithm used the same types of patient data from a separate set of 2,400 visits, and accurately predicted a MI in 94 percent of cases. Researchers also ran the validation data through a standard clinical model, which showed an accuracy of 88 percent. The results suggest the machine learning approach could offer a substantial improvement over current decision-support tools, researchers said. 

In another study looking at technology in cardiovascular care, researchers tracked search engine queries to assess whether searches on heart disease symptoms closely followed geographic and seasonal trends for coronary heart disease hospitalizations. Conor Senecal, MD, et al., analyzed how frequently people in the U.S., United Kingdom and Australia used Google to search for chest pain, chest discomfort, chest pressure or angina. The study focused on two questions: whether the geographic distribution of relevant search queries reflected that of heart disease hospitalizations, and whether the timing of search queries reflected seasonal trends in heart disease hospitalizations. Researchers found a strong correlation between the search queries and hospitalizations, and reported that queries followed seasonal trends relatively well, with significant spikes in the winter and dips in the summer in the U.S. and U.K. In Australia, queries peaked in the Southern Hemisphere autumn and dipped in the spring, aligning with previous research on Australia’s seasonal heart disease trends.

Meanwhile, a separate study found that a specialized wristband and corresponding smartwatch app might accurately detect atrial fibrillation (AFib). The blinded, prospective study enrolled 100 AFib patients who presented for a scheduled electrical cardioversion. Patients were given a smartwatch with the special wristband and then underwent a standard electrocardiogram (ECG). If cardioversion was indicated, both tests were repeated after the procedure. Led by Joseph Bumgarner, MD, researchers compared the smartwatch interpretations with the physician-reviewed standard ECG. The algorithm detected AFib with 93 percent sensitivity and 84 percent specificity, when compared with the ECG. Based on their findings, Bumgarner said the device may lead to cost savings and could potentially help avoid unnecessary procedures.

CV Risk in Football Players

In other new research, Dermot Phelan, MB BCH, PhD, FACC, et al., conducted a screening of 460 former National Football League (NFL) players that included an ECG, echocardiogram, blood tests and a cardiovascular history questionnaire. They compared the results to a sample of 925 people from the general public with similar demographics. After controlling for blood pressure, body mass index, age and race, researchers found the NFL players were 5.5 times more likely than nonathletes to have AFib and other signs of abnormal electrical impulses. 

In a separate study, Jonathan Kim, MD, FACC, et al., performed echocardiography and vascular applanation tonometry on college freshmen – 136 who played football and 44 who did not, both before and after a complete football season. Results showed that all participants gained weight after football season, but football players showed significant enlargement of the aortic root. Although the athletes’ aortic roots were still within the normal range, enlargement of the aortic root may not completely be a consequence of exercise training, researchers said.

Flu Vaccine in HF

Another study examined whether HF patients who received a seasonal influenza vaccine had a decreased risk of death. Hidekatsu Fukuta, MD, et al., analyzed six studies conducted in the U.S., Europe and Asia that included data from more than 78,000 HF patients. According to the results, getting the flu vaccine reduced the risk of death from any cause by about 50 percent during flu season and by about 20 percent during the rest of the year. Vaccination also was associated with a 22 percent reduction in the risk of a cardiovascular-related hospitalization. The authors conclude that their results support wider use of influenza vaccination in HF patients. 

Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Sports and Exercise Cardiology, EP Basic Science, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure, Echocardiography/Ultrasound, Exercise, Sports and Exercise and Imaging

Keywords: ACC18, ACC Annual Scientific Session, Influenza Vaccines, Electric Countershock, Football, Body Mass Index, Atrial Fibrillation, Blood Pressure, Prospective Studies, Athletes, Unnecessary Procedures, Decision Trees, Reference Values, Cardiovascular Diseases, Cost Savings, Influenza, Human, Search Engine, Risk Factors, Electrocardiography, Angina Pectoris, Body Weight, Myocardial Infarction, Echocardiography, Coronary Disease, Vaccination, Heart Failure, Emergency Service, Hospital, Hospitalization, Artificial Intelligence, Demography, Algorithms, Hematologic Tests, Exercise, ACC Scientific Session Newspaper

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