Publications by authors named "Vicente Grau"

Cardiac anatomy and physiology vary considerably across the human population. Understanding and taking into account this variability is crucial for both accurate clinical decision-making and realistic in silico modeling of cardiac function. In this work, we propose multi-class variational point cloud autoencoders (Point VAE) as a novel geometric deep learning approach for 3D cardiac shape and function analysis.

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Heart failure (HF) poses a significant public health challenge, with a rising global mortality rate. Early detection and prevention of HF could significantly reduce its impact. We introduce a novel methodology for predicting HF risk using 12-lead electrocardiograms (ECGs).

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Background: Cardiometabolic disturbances play a central role in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). Due to its complexity, HFpEF is a challenging condition to treat, making phenotype-specific disease management a promising approach. However, HFpEF phenotypes are heterogenous and there is a lack of detailed evidence on the different, sex-specific profiles of cardiometabolic multimorbidity and metabolic syndrome present in HFpEF.

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Background: 12-lead electrocardiograms (ECGs) are a cornerstone for diagnosing and monitoring cardiovascular diseases (CVDs). They play a key role in detecting abnormalities such as arrhythmias and myocardial infarction, enabling early intervention and risk stratification. However, traditional analysis relies heavily on manual interpretation, which is time-consuming and expertise-dependent.

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Invasive coronary angiography (ICA) is the gold standard imaging modality during cardiac interventions. Accurate segmentation of coronary vessels in ICA is required for aiding diagnosis and creating treatment plans. Current automated algorithms for vessel segmentation face task-specific challenges, including motion artifacts and unevenly distributed contrast, as well as the general challenge inherent to X-ray imaging, which is the presence of shadows from overlapping organs in the background.

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Cardiac digital twins (CDTs) offer personalized in-silico cardiac representations for the inference of multi-scale properties tied to cardiac mechanisms. The creation of CDTs requires precise information about the electrode position on the torso, especially for the personalized electrocardiogram (ECG) calibration. However, current studies commonly rely on additional acquisition of torso imaging and manual/semi-automatic methods for ECG electrode localization.

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Cardiovascular diseases (CVDs) are the most common health threats worldwide. 2D X-ray invasive coronary angiography (ICA) remains the most widely adopted imaging modality for CVD assessment during real-time cardiac interventions. However, it is often difficult for the cardiologists to interpret the 3D geometry of coronary vessels based on 2D planes.

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Cardiac digital twins (CDTs) are personalized virtual representations used to understand complex cardiac mechanisms. A critical component of CDT development is solving the ECG inverse problem, which enables the reconstruction of cardiac sources and the estimation of patient-specific electrophysiology (EP) parameters from surface ECG data. Despite challenges from complex cardiac anatomy, noisy ECG data, and the ill-posed nature of the inverse problem, recent advances in computational methods have greatly improved the accuracy and efficiency of ECG inverse inference, strengthening the fidelity of CDTs.

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Background: Type 2 diabetes mellitus (T2DM) is a major risk factor for heart failure with preserved ejection fraction and cardiac arrhythmias. Precursors of these complications, such as diabetic cardiomyopathy, remain incompletely understood and underdiagnosed. Detection of early signs of cardiac deterioration in T2DM patients is critical for prevention.

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Article Synopsis
  • ARDS is a severe respiratory failure condition with poor oxygenation, and recent advancements in machine learning offer new ways to classify and manage it.
  • A systematic review analyzed 243 studies published between 2009 and 2023, focusing on machine learning applications for ARDS, with 52 studies selected for in-depth review.
  • The findings indicate that gradient boosting is the most frequently used method, while a more extensive dataset is necessary for neural networks to be effective; improving the explainability and validation of models with clinician input is essential for better management of ARDS.
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Global single-valued biomarkers, such as ejection fraction, are widely used in clinical practice to assess cardiac function. However, they only approximate the heart's true 3D deformation process, thus limiting diagnostic accuracy and the understanding of cardiac mechanics. Metrics based on 3D shape have been proposed to alleviate these shortcomings.

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Article Synopsis
  • - This study explores the use of advanced techniques to analyze left ventricular contraction in 1021 survivors of acute myocardial infarction (AMI) using Cardiac Magnetic Resonance (CMR), focusing on patterns that may indicate risk for major adverse cardiac events (MACE).
  • - Researchers analyzed cardiac function through three methods: volume temporal transients, feature tracking strain analysis, and 3D shape analysis, using a fully automated system to derive new metrics along with traditional ones.
  • - By combining results from these three methods, the predictive accuracy for MACE improved by 13% compared to existing clinical models, demonstrating that this new characterization approach enhances risk assessment following heart attacks.
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Cardiac in silico clinical trials can virtually assess the safety and efficacy of therapies using human-based modelling and simulation. These technologies can provide mechanistic explanations for clinically observed pathological behaviour. Designing virtual cohorts for in silico trials requires exploiting clinical data to capture the physiological variability in the human population.

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Cardiac digital twins (CDTs) have the potential to offer individualized evaluation of cardiac function in a non-invasive manner, making them a promising approach for personalized diagnosis and treatment planning of myocardial infarction (MI). The inference of accurate myocardial tissue properties is crucial in creating a reliable CDT of MI. In this work, we investigate the feasibility of inferring myocardial tissue properties from the electrocardiogram (ECG) within a CDT platform.

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The Segment Anything Model (SAM) is the first foundation model for general image segmentation. It has achieved impressive results on various natural image segmentation tasks. However, medical image segmentation (MIS) is more challenging because of the complex modalities, fine anatomical structures, uncertain and complex object boundaries, and wide-range object scales.

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Myocardial infarction (MI) is one of the most prevalent cardiovascular diseases with associated clinical decision-making typically based on single-valued imaging biomarkers. However, such metrics only approximate the complex 3D structure and physiology of the heart and hence hinder a better understanding and prediction of MI outcomes. In this work, we investigate the utility of complete 3D cardiac shapes in the form of point clouds for an improved detection of MI events.

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Purpose: This study aimed to determine the association between functional impairment in small airways and symptoms of dyspnea in patients with Long-coronavirus disease (COVID), using imaging and computational modeling analysis.

Patients And Methods: Thirty-four patients with Long-COVID underwent thoracic computed tomography and hyperpolarized Xenon-129 magnetic resonance imaging (HP Xe MRI) scans. Twenty-two answered dyspnea-12 questionnaires.

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Cine magnetic resonance imaging (MRI) is the current gold standard for the assessment of cardiac anatomy and function. However, it typically only acquires a set of two-dimensional (2D) slices of the underlying three-dimensional (3D) anatomy of the heart, thus limiting the understanding and analysis of both healthy and pathological cardiac morphology and physiology. In this paper, we propose a novel fully automatic surface reconstruction pipeline capable of reconstructing multi-class 3D cardiac anatomy meshes from raw cine MRI acquisitions.

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Multi-modality cardiac imaging plays a key role in the management of patients with cardiovascular diseases. It allows a combination of complementary anatomical, morphological and functional information, increases diagnosis accuracy, and improves the efficacy of cardiovascular interventions and clinical outcomes. Fully-automated processing and quantitative analysis of multi-modality cardiac images could have a direct impact on clinical research and evidence-based patient management.

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In recent years, several deep learning models have been proposed to accurately quantify and diagnose cardiac pathologies. These automated tools heavily rely on the accurate segmentation of cardiac structures in MRI images. However, segmentation of the right ventricle is challenging due to its highly complex shape and ill-defined borders.

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Cardiac anatomy and function vary considerably across the human population with important implications for clinical diagnosis and treatment planning. Consequently, many computer-based approaches have been developed to capture this variability for a wide range of applications, including explainable cardiac disease detection and prediction, dimensionality reduction, cardiac shape analysis, and the generation of virtual heart populations. In this work, we propose a variational mesh autoencoder (mesh VAE) as a novel geometric deep learning approach to model such population-wide variations in cardiac shapes.

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Cardiac magnetic resonance (CMR) imaging is the one of the gold standard imaging modalities for the diagnosis and characterization of cardiovascular diseases. The clinical cine protocol of the CMR typically generates high-resolution 2D images of heart tissues in a finite number of separated and independent 2D planes, which are appropriate for the 3D reconstruction of biventricular heart surfaces. However, they are usually inadequate for the whole-heart reconstruction, specifically for both atria.

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Whilst the electrocardiogram (ECG) is an essential tool for diagnosing cardiac electrical abnormalities, its characteristics are dependent on anatomical variability. Specifically variation in torso geometry affects relative positions of the leads with respect to the heart. We propose a novel pipeline that uses standard cardiac magnetic resonance images to reconstruct the torso and heart, and recreate the ECG considering torso and cardiac anatomy.

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Human cardiac function is characterized by a complex interplay of mechanical deformation and electrophysiological conduction. Similar to the underlying cardiac anatomy, these interconnected physiological patterns vary considerably across the human population with important implications for the effectiveness of clinical decision-making and the accuracy of computerized heart models. While many previous works have investigated this variability separately for either cardiac anatomy or physiology, this work aims to combine both aspects in a single data-driven approach and capture their intricate interdependencies in a multi-domain setting.

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