Johns Hopkins cardiologist Joseph Marine, MD after the AHA forecast astounding CVD increases through 2050.

Structural heart care has undergone a massive evolution in recent years, driving a similar transformation in structural heart imaging. In the latest Cardiac Wire Show, Duly Health’s director of cardiac imaging Sujith J. Kalathiveetil, MD, FACC explores these trends and outlines how cardiovascular imaging teams can stay prepared for structural heart’s continued evolution.

Artificial Intelligence

Philips Expands & Integrates Echo AI Platform

Philips’ ultrasound AI strategy took another big step this week, with the launch of its next-generation echo AI platform, which will come integrated with the company’s cardiovascular ultrasound systems and bring a range of new echo-automating capabilities. 

Philips’ new AI-enabled cardiovascular ultrasound platform includes a combination of established and first-to-market AI applications that come fully integrated with its EPIQ CVx and Affiniti CVx echo scanners, with a focus on speeding up echo teams’ cardiac ultrasound analysis.

The announcement specifically highlighted Philips’ first-of-their-kind…

• Segmented Wall Motion app – an automated tool for segmental wall motion scoring and identifying disorders such as coronary artery disease and cardio-oncology issues.
• 3D Mitral Regurgitation Volume Quantification app – a tool for the automated analysis of MR flow dynamics, supporting valve treatment decision-making (not yet FDA cleared).

The platform also includes solutions for automated LVEF measurements, LV strain analysis, and the automated selection of the most appropriate LV images.

Philips has been developing echo AI solutions for some time through its ultrasound and Tomtec teams, and boosted its echo AI portfolio and development capabilities through its acquisition of DIA Image Analysis almost exactly one year ago.

However, this launch is perhaps most notable for bringing the “deep” integration of AI tools into Philips’ cardiovascular ultrasound systems, making AI a core part of its scanners’ feature set and value proposition, rather than an add-on.

• That integration could be particularly notable from a usability perspective, and could also help drive AI adoption given the continued barriers experienced when selling / buying AI as standalone solutions. 
• It might also be a sign of an echo AI integration trend, noting that GE HealthCare has been steadily expanding its Caption AI echo guidance solution to more of its echo scanners since acquiring Caption Health last year.

The Takeaway

With all the imaging AI acquisitions that have taken place over the last few years, Philips’ echo AI integration is a reminder why the only acquisitions made by the big OEMs targeted cardiovascular ultrasound AI solutions (no other indications or modalities). 

AI tools like these make cardiovascular ultrasound systems faster and easier to use, and scanner integrations like these might have a multiplying effect on echo AI’s adoption and overall impact.

Accurate and Efficient Remote Cardiac Patient Monitoring

The expansion of remote cardiac patient monitoring is creating more care opportunities, but also new operational challenges for cardiology teams. Check out this Cardiac Wire Show, where ARTELLA Solutions’ Jacinta Fitzsimons shares how the right combination of technology and service can help physicians get the most out of their cardiac RPM programs – today and into the future.

HeartFlow FFRCT’s Real World Impact

See how HeartFlow FFRCT Analysis significantly improved NHS England’s patient outcomes and clinical efficiency in a massive real world implementation across 90k patients in this presentation by Newcastle University’s Professor Vijay Kunadian.

Your Cardiology Data is Valuable. Put it To Work.

See how one major Midwest health system’s decision to implement Merge Cardio transformed physician and staff workflows, improved data entry speed and accuracy, and increased cost savings.

The Wire

• Heart Disease in 2050: An AHA Presidential Advisory warned of massive heart disease increases in the US by 2050, revealing some truly astounding numbers. The AHA predicts huge increases in CVD (+60% to 45m), diabetes (+100% to 80M), obesity (+70% to 180M), hypertension (+44% to 180M), heart failure (+66% to 11M), and stroke (+100% to 19M). Add all that up and the cost of treating adult CVD and stroke patients will increase by 195% to $1.85 trillion, representing 4.6% of US GDP.

• HeartFlow Plaque Medicare Milestone: HeartFlow’s AI-based Plaque Analysis solution hit a Medicare coverage milestone, after five Medicare Administrative Contractors released draft Local Coverage Determinations (LCD) for AI + CT-based coronary plaque analysis. The draft LCDs represent the first step toward securing reimbursements for AI-based plaque analysis, which would be followed by an input period, and then potentially finalizing the policy. Although AI reimbursements are still rare, HeartFlow has been a trailblazer for cardiovascular AI coverage, starting with its FFRCT Analysis solution several years ago.

• Triglycerides Plummet with Plozasiran: Arrowhead Pharmaceuticals reported positive topline results for its triglyceride-lowering RNAi therapeutic plozasiran in the Phase 3 PALISADE study. Among 75 patients with chylomicronemia syndrome (FCS), triglycerides dropped by up to 80% and APOC3 fell by up to 94% after 10 months of plozasiran treatment, while adverse event rates were similar for plozasiran and placebo. Arrowhead hopes to file plozasiran for FDA approval as an FCS treatment.

• FDA Approves Entresto Generics: The FDA approved the first generics of Novartis’ blockbuster heart failure drug Entresto, which will be available in a range of dosages. Novartis fought to delay the approval of Entresto generics up until now, although generic drugmakers are now likely poised to make a big entrance into HF care, noting that Entresto racked up the 6th highest total Medicare Part D costs as of 2023.

• Intermittent Fasting Post-MI: Intermittent fasting may lead to better STEMI recoveries. In the INTERFAST-MI study of 48 STEMI patients, a group randomized to intermittent fasting for four weeks had significantly improved left ventricular ejection fraction compared to participants on a regular diet (+6.6% vs. +1.5%). Intermittent fasters also benefited from greater reductions in diastolic blood pressure and body weight.

• Caristo CTA AI Predicts CV Risk: A new study suggests that Caristo Diagnostics’ CaRi-Heart AI software can accurately predict future cardiac risk by analyzing coronary arterial inflammation in CTA scans. Researchers performed Caristo AI-analysis on CTAs from 40k patients, and followed 3.4k higher-risk patients for 7.7 years. Across the entire 40k cohort, patients without obstructive CAD (surprisingly) accounted for 64% of cardiac deaths and 66% of MACE. In the higher-risk cohort, patients with elevated “perivascular fat attenuation index” scores had far higher risks of cardiac mortality (HR=29.8) and MACE (HR=12.6).

• The Fish Are On Heart Drugs: West Virginia University researchers found that statins and beta blockers are making their way through sewage treatment plants and into the bodies of the fish living in the state’s rivers. Treatment facilities aren’t designed to filter out these partially-digested drugs, which are so common they are continuously being deposited into WV’s waterways, potentially impacting the fishes’ health and ability to reproduce.

• Sacubitril’s Uneven Uptake: A new study out of the University of Florida found that patient adherence to the ARNI sacubitril/valsartan, lags in many populations. Analysis of Medicare data from 9,475 beneficiaries showed that Black patients were 1.36 times less likely to maintain their prescription than white patients, while patients with comorbidities or living in socioeconomically disadvantaged areas were also less likely to adhere to their sacubitril prescriptions.

• Eko Series D: Eko Health raised $41M in Series D funding (total raised now $165M) to deepen its commercial presence in the US and fund its international expansion. Eko Health is best known for its smart stethoscope, although the announcement revealed what appears to be a broader focus on AI-enabled heart and lung disease detection, with ten mentions of “AI” or “algorithms,” and just one mention of its stethoscopes at the very bottom of the press release. 

• Albuminuria’s Silent Threat: A study of almost 13k people from the NHANES registry found that even low levels of albuminuria (urinary albumin:creatinine ratio <30 mg/g) were linked to higher cardiovascular and all-cause mortality in adults without major heart risk factors. Over a 12-year follow-up period, each doubling of the albumin:creatinine ratio increased cardiovascular death risk by 36% and all-cause mortality by 24%. This suggests that even “normal” albuminuria levels may be a sign of higher health risks.

• Melatonin Not Linked to Heart Disease or Diabetes: New data suggests that melatonin supplements don’t increase risks of type 2 diabetes or cardiovascular disease, and might actually reduce the CV risks of working overnight shifts. Researchers followed 160k medical professionals for up to 23 years, finding that melatonin-takers had slightly lower risks of CVD and type 2 diabetes (hazard ratios: 0.94 & 0.98). Additionally, melatonin use appeared to reduce the association between long-term night shift work (>5 years) and cardiovascular disease.

Experience the Future of Learning: Medtronic Academy 2.0 is Here!

Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!

The Bunkerhill Blueprint

Advancing an AI solution from concept to clinic used to take years, but Bunkerhill Health is closing that gap at lightning speed. See how Bunkerhill is streamlining AI training, validation, approval, and commercialization to get better AI tools into clinical practice, faster.

The Resource Wire

• Can AI Prevent Heart Disease Progression? Tune in to Cleerly’s on-demand webinar where study leaders will discuss how the landmark TRANSFORM randomized controlled trial will test whether an AI-personalized care strategy can outperform traditional risk factor management and prevent cardiovascular events.

• Making the Leap to Outsource Post-Processing: Interested in how to outsource cardiac image post-processing, but not sure where to start? PIA walks you through how to assess and compare vendors, understand pricing models and payment options, and outline your requirements to identify vendors who meet your clinical needs.

• Advance Your TAVR Planning: Ready to advance your TAVR planning? See how you could leverage TeraRecon’s TAVR (Vessel Analysis) package to streamline and enhance your aortic valve replacement measurements.

• Echo AI for HFpEF: New research comparing Us2.ai to gold-standard invasive hemodynamic measurement showed that in patients with HFpEF, echo AI measurements are interchangeable with manual core-lab measures to diagnose increased filling pressures – and could improve HFpEF detection.