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AI Identified These 5 Types Of Heart Failure In New Study: 'Interesting To Differentiate'
"Heart failure" is a catch-all term used to describe any condition in which the organ doesn't work as it's supposed to — but one person's experience with the disease can be very different from someone else's.
Researchers from the University College London (UCL) recently used machine learning — a type of artificial intelligence — to pinpoint five distinct types of heart failure, with the goal of predicting the prognosis for the different kinds.
"We sought to improve how we classify heart failure, with the aim of better understanding the likely course of disease and communicating this to patients," said lead author Professor Amitava Banerjee from UCL in a press release announcing the study.
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"Currently, how the disease progresses is hard to predict for individual patients," he also said. "Some people will be stable for many years, while others get worse quickly."
The five types of heart failure identified were early onset, late onset, atrial fibrillation (which causes an irregular heart rhythm), metabolic (linked to obesity but with a low rate of cardiovascular disease) and cardiometabolic (linked to obesity and cardiovascular disease), according to a press release on UCL's website.
For each type of heart failure, the researchers determined the likelihood of the person dying within a year of diagnosis. The prognosis varied widely for the five subtypes, they found. (iStock)
"The five types of heart failure were on the basis of common risk factors, such as age at onset of heart failure, history of cardiac disease, history of cardiac risk factors such as diabetes and obesity, or atrial fibrillation (the commonest heart rhythm problem)," explained Banerjee in a statement to Fox News Digital.
For the study, published in the journal Lancet Digital Health, the researchers analyzed data from more than 300,000 U.K. Adults aged 30 and older who had experienced heart failure over a 20-year period.
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"Four methods of machine learning were used to cluster individuals with heart failure in electronic health data by their baseline characteristics," said Banerjee. "The method and the number of clusters that 'fit' best to the data were selected."
For each type of heart failure, the researchers determined the likelihood of the person dying within a year of diagnosis. The prognosis varied widely for the five subtypes, they found.
The five-year mortality risk was 20% for early onset, 46% for late onset, 61% for atrial fibrillation-related, 11% for metabolic and 37% for cardiometabolic, according to the press release.
The main limitation of the new study from UCL was that the researchers didn't have access to any imaging data, which is most commonly used to diagnose and predict risk in heart failure. (iStock)
For health professionals, Banerjee recommends that they ask their heart failure patients about common risk factors to help them understand the subtype they have.
"Researchers also need to test how usable, generalizable and acceptable these subtypes defined in our study are in clinical practice," he added.
"They should also consider whether studies such as ours, which use AI, can help inform a better understanding of disease processes and drug discovery."
The research team also developed an app for physicians that would enable them to determine which subtype of heart failure a patient has — with the goal of better predicting risk and keeping patients informed.
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Dr. Ernst von Schwarz, a triple board-certified clinical and academic cardiologist at UCLA in California, reviewed the results of UCL's study.
"For clinicians, it is interesting to differentiate heart failure according to prognosis, which usually is not done in the clinical setting," he told Fox News Digital. "Heart failure is generally seen as an incurable, chronic, progressive disease with poor long-term outcomes."
"Heart failure is generally seen as an incurable, chronic, progressive disease with poor long-term outcomes."
"Studies like this might help clinicians make a more appropriate risk assessment according to the etiology of heart failure," von Schwarz added.
In particular, the very high mortality rate for atrial fibrillation-induced heart failure highlights the importance of aggressively managing this common arrhythmia, he said.
Researchers used machine learning — a type of artificial intelligence — to pinpoint five distinct types of heart failure. (iStock)
The mortality predictions for the five subtypes are "by far the most interesting part of this data," according to Dr. Matthew Goldstein, a physician at Cardiology Consultants of Philadelphia, who also reviewed the study findings.
"This may help us guide who is at risk for dying suddenly, and thus, who needs protection with a defibrillator and who does not," he added.
AI shows promise, but limitations remainWhile Goldstein recognizes that AI is becoming more common in general, he believes its application is medicine has shown "somewhat less success."
He told Fox News Digital, "It is, however, good at looking for patterns that are too complicated for the human mind to see."
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"Some of the more common utilizations are automatic readings of radiology studies to make sure that nothing is missed and emerging use in EKG interpretation to suggest underlying pathology," he added.
In terms of using AI to classify heart failure, Goldstein noted that this is only a retrospective study and will need to be proven for future cases in order to be truly useful.
Looking aheadThe main limitation of the new study was that the researchers didn't have access to any imaging data, which is most commonly used to diagnose and predict risk in heart failure.
"However, imaging markers alone do not predict mortality and other outcomes," Banerjee said.
"The fact that we were able to use routinely collected data without this imaging data to predict subtypes and outcomes relatively well suggests that the imaging biomarkers alone may not be the best way to characterize and study heart failure at population scale."
Using these findings as a foundation, Professor Banerjee of UCL said the next step is to determine whether these heart failure classifications can make a practical difference to patients. (iStock)
The next step, Banerjee said, is to determine whether classifying various heart failures can make a practical difference to patients — "whether it improves predictions of risk and the quality of information clinicians provide, and whether it changes patients' treatment."
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Cost-effectiveness is another consideration, he added.
The UCL research team previously used similar methods to identify subtypes in chronic kidney disease.
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Looking ahead, Banerjee expects that machine learning will be used to analyze many types of routinely collected medical data and to identify subtypes of different diseases.
Melissa Rudy is health editor and a member of the lifestyle team at Fox News Digital.
Many Aussies At Risk Of Heart Failure Have No Idea
Australians have improved in a number of areas related to looking after their health in recent decades. The number of people on the streets, cigarette in hand, is dramatically lower than 30 years ago. That's good news for our hearts and lungs, but has it led to complacency? Maybe so, if the latest research is any guide. It suggests that two in three Australians at risk of developing heart failure are unaware of that fact.
What's more, more than 80 per cent of Australians aged over 65 are unaware that age is a risk factor. For all our improvements, heart failure remains a leading cause of death in Australia. Up to half a million Aussies are affected, and each day eight Australians die as a result of heart failure.
The research incorporated a study that surveyed more than 1000 Australians aged 18 years and older in May this year. It has been published in a report commissioned by Australian charity 'hearts4heart'.
What does the term 'heart failure' mean?This is a very good question, and I was unaware myself of what the term entails. Associate Professor John Amerena, director of the Geelong Cardiology Research Unit, has enlightened me. "Heart failure doesn't mean your heart has failed, but rather that it's failing to keep up with your body's demands," he said.
Perhaps not as serious as it sounds, then? Not if you do something about it before it's too late, says Prof. Amerena. "When left untreated, heart failure progressively worsens," he said. "But with early diagnosis, treatment and lifestyle changes, a person with heart failure can reduce their risk of hospitalisation and improve their quality of life."
Prof. Amerena's comments accompanied the announcement of the hearts4heart report's survey results. The mission of hearts4heart, a Melbourne-based organisation, is "to eliminate preventable strokes, deaths and suffering for people living with heart disease".
And its vision is to do so through "targeted support, education and advocacy for those living with heart disease".
Steps Australians can take to reduce riskAs part of this year's Heart Failure Awareness Week campaign, hearts4heart has produced a comprehensive new guide.
Understanding Heart Failure – A Practical Guide for all Australians provides a clear explanation of how the heart functions. It also details the causes and symptoms of heart failure, and provides advice for those diagnosed with heart failure.
The guide also features personal stories and experiences, including that of Katrina Tenne. Ms Tenne initially underestimated her risk, despite her family's history of cardiomyopathy. She has now shared her story to encourage Australians to prioritise their heart health and seek support when needed.
"Heart disease is all around us, but we don't think it will actually happen to us." Ms Tenne said. "If you are always feeling tired, your body is trying to tell you something. Speak to your GP about your symptoms."
You could do worse than take the advice of Ms Tenne. Having lost an uncle and grandfather to heart failure, she initially ignored her own symptoms before taking action.
"Seeing my cardiologist was the best thing I could have done for my health," she said. "If you are always feeling tired or wanting to sleep, your body is trying to tell you something. Do what your body tells you to do. See your doctor."
How well do you feel you know the potential risks to your heart? Were you aware that age is a risk factor? Let us know in the comments section below.
Also read: What your heart rate means
Health disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.
Congestive Heart Failure: Stages And Types
Systolic congestive heart failure occurs when the heart does not pump blood effectively. There are 4 stages of congestive heart failure.
Congestive heart failure may happen when the heart muscle is too weak or when another health problem prevents it from circulating blood efficiently. Over time, systolic congestive heart failure, or heart failure (HF), can lead to dysfunction of other organs due to inefficient pumping.
This article discusses how HF progresses over time and explains the outlook for people with this condition. It also examine the causes, symptoms, treatment options, and stages.
There are four different stages of systolic heart failure: A, B, C, and D.
When the condition progresses to the next stage, a person's chance of surviving decreases.
People with stage A HF do not yet have dysfunction of the pumping activity of the heart but have a high risk of developing HF due to related conditions, such as chronic high blood pressure, diabetes, and coronary artery disease.
SymptomsA person usually has no symptoms of HF at this stage but may experience symptoms of their chronic conditions, including:
People with this stage HF have no problems with the structure of the heart or how their heart works. Treatment should focus on managing risk factors.
Structural heart disease develops at this stage, such as reduced pumping function of the heart, which can lead to an enlarged left ventricle. It can also result from a previous heart attack.
SymptomsMost people at stage B still do not show symptoms of HF.
OutlookA doctor may prescribe medication at this stage for the management and prevention of future problems. It is common for a doctor to prescribe ACE inhibitors/ARB or ARNI and beta blockers at this stage.
People at this stage will show symptoms of HF linked to underlying structural heart disease, including fatigue or breathlessness. These symptoms usually occur due to problems with the squeezing function of the left ventricle, or the pumping chamber of the heart.
Stage C HF also includes people who no longer show symptoms but are currently undergoing treatment for previous symptoms, such as those who spent time in the hospital with heart failure exacerbation.
SymptomsCommon symptoms include:
A doctor will definitely prescribe medication at this stage for the management and prevention of future problems. It is common for a doctor to prescribe diuretics, ACE inhibitors/ARB/ARNI and beta blockers, mineralocorticoid receptor blockers, or SGLT2 inhibitors at this stage.
A doctor also may consider implantable cardioverter-defibrillators and cardiac resynchronization therapy at this stage.
At stage D, people will have advanced structural heart disease and display significant symptoms, even when they are at rest.
SymptomsSymptoms may include:
This stage is severe and may require advanced specialized treatment. Such as mechanical circulatory support, continuous inotropic infusion to make the heart squeeze harder, cardiac transplant, or hospice care.
The most common type of HF is left-sided HF. The left side of the heart must work harder to move the same volume of blood around the body. This may cause a fluid buildup in the lungs and make breathing difficult as it progresses.
These fluids give congestive heart failure its name.
There are two kinds of left-sided HF.
With systolic heart failure, the left ventricle cannot contract normally, limiting the heart's pumping ability. The stages of HF only refer to systolic heart failure and not the other types.
With diastolic heart failure, the muscle in the left ventricle stiffens. If the muscle cannot relax, the pressure in the ventricle increases, causing symptoms.
Right-sided HF is less common. It occurs when the right ventricle cannot pump blood to the lungs. This can lead to blood backing up in the blood vessels, which may cause fluid retention in the lower legs and arms, abdomen, and other organs.
A person can have left-sided and right-sided HF at the same time. However, HF usually begins on the left side and can affect the right side if a person does not receive effective treatment.
Symptoms of HF range from mild to severe but may get worse over time if not managed medically.
Lifestyle strategies can reduce the risk of developing HF and can also slow its progress.
To prevent or slow the progression of HF, people should take the following steps:
People who already have HF should take the following steps to prevent further progression:
Without treatment, HF can be fatal. Even with adequate treatment, HF may get worse over time, triggering dysfunction of other organs throughout the body.
HF is more likely to occur in people with other conditions or lifestyle factors that weaken the heart.
Risk factors for HF include:
A doctor or cardiologist will perform a physical exam. This involves listening to the heart, checking for fluid retention, and looking at the veins in the neck to see if there is extra fluid present in the heart. They may order other diagnostic tests, including:
Systolic congestive heart failure occurs when the heart does not pump blood effectively. It may happen for a variety of reasons such as a weak heart muscle or underlining health problems.
There are several stages of systolic congestive heart failure and each stage requires a different treatment. Lifestyle changes, medication, and surgery are typical methods of treatment.
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