Using an Artificial Neural Network to Predict Coronary Microvascular Obstruction (No-Reflow Phenomenon) during Percutaneous Coronary Interventions in Patients with Myocardial Infarction

Abstract

The aim of the study was to develop, evaluate, and validate an artificial neural network to predict coronary microvascular obstruction (CMVO) during percutaneous coronary interventions (PCI) in patients with myocardial infarctions (MI) based on the parameters, which are routinely available in an operating room when choosing a surgical approach.Materials and Methods. 5621 patients with MI and emergency PCI were retrospectively selected from the database of the City Clinical Hospital No.13 (Nizhny Novgorod, Russia); among them, there were 3935 men (70%) and 1686 women (30%), their mean age was 61.5±10.8 years. CMVO was recorded in 201 (4%) patients (the blood flow in the infarction-related artery after PCI was less than 3 points according to TIMI flow grade). The following input parameters were assessed: age, gender, past history of coronary artery disease, previous revascularization, presence of ST-segment elevation, a class of acute heart failure, a fact of systemic thrombolytic therapy administration and its effectiveness, symptom-to-balloon time, severity of coronary thrombosis and atherosclerosis, the number of stents and the number of operated coronary arteries. The sampling was divided into a training group (n=4060), a testing group (n=717), and an independent validation group (n=844).Results. We developed an artificial neural network by a fully connected multilayer perception with forward signal propagation and two hidden layers (the area under the ROC curve -0.69) to predict CMVO based on the subsampling for training and testing. The network model was tested on an independent subsampling (the area under the ROC curve -0.64, negative predictive value -97.4%, positive predictive value -14.6%). Conclusion.The developed artificial neural network enables to use the parameters routinely available in an operating room when choosing a surgical approach and predict CMVO development during PCI in MI patients with accuracy sufficient for practical use.

Experience of Using Neural Networks to Assess Age-Related Changes in Some Structures of the Skull and Cervical Vertebrae Based on СТ Scans (Pilot Project)

“…The morphometric assessment of age changes in frontal and sphenoid sinuses consisted in determining the geometry of sinuses and their dimensional characteristics using the PjaPro program [16,18]. In the process of our investigation, 17 metric parameters of the frontal and sphenoid sinuses have been analyzed (features 1-17 in the Table ).…”

“…For example, traditional algorithms, based on manual programming of functions, were successfully replaced owing to the implementation of a computer vision [9][10][11][12]. In medical practice, deep neural networks are employed to detect patterns of interstitial lung diseases on the CT scans of the thoracic organs [13,14]; for segmentation of the human vascular eye network on the photographs of the ocular bottom [15]; prediction of coronary microvascular obstruction phenomenon developing in the process of percutaneous coronary interventions [16]; and also for estimation of age by hand [17] and teeth [8] rentgenograms. An important advantage of the deep neural networks is the ability to obtain high-level hierarchical image representation [18].…”