Continuous monitoring of left ventricular function by transesophageal echocardiography and artificial intelligence

Abstract

Sudden changes in the circulation are unavoidable in intensive care patients. An effective strategy to combat these unavoidable yet unpredictable changes is continuously monitoring their circulation. As the blood for circulation is pumped by the heart’s left ventricle (LV), it is both unfortunate and perplexing that LV function is rarely continuously monitored in these patients. One reason for this paradox is that the current method for assessing LV function is too impractical for continuous monitoring. Proper assessment of LV function requires echocardiography, a laborious method that demands too much time from the otherwise busy clinician. To address this issue, we have developed a new method for quicker and easier assessments of LV function. Our method combines transesophageal echocardiography (TEE) and artificial intelligence (AI) to automatically monitor LV function. We call the method autoMAPSE because the chosen parameter of LV function is mitral annular plane systolic excursion (MAPSE). Thus, we asked whether autoMAPSE could serve as a tool for continuous monitoring of LV function in intensive care patients. To answer this, we first determined whether autoMAPSE was feasible in these patients. Next, we refined the technology for faster analysis of MAPSE at the patients' bedside. Finally, we applied autoMAPSE for continuous monitoring as we foresee its potential use in the future. Our results demonstrate how autoMAPSE can provide continuous monitoring of LV function by providing quick, easy, and precise measurements of LV function, thus overcoming a longstanding limitation of echocardiography. Continuous monitoring of LV function using autoMAPSE also complements the practice of hemodynamic monitoring, which has hitherto focused on arterial pressure and flow, rather than on LV function. To summarize, by providing continuous monitoring of LV function in intensive care patients, autoMAPSE can expand the scope of both echocardiography and hemodynamic monitoring.