{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:03:17Z","timestamp":1791223397757,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To test the hypothesis that deep learning (DL) networks reliably detect pulmonary arterial hypertension (PAH) and provide prognostic information.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Consecutive patients with PAH, right ventricular (RV) dilation (without PAH), and normal controls were included. An ensemble of deep convolutional networks incorporating echocardiographic views and estimated RV systolic pressure (RVSP) was trained to detect (invasively confirmed) PAH. In addition, DL-networks were trained to segment cardiac chambers and extracted geometric information throughout the cardiac cycle. The ability of DL parameters to predict all-cause mortality was assessed using Cox-proportional hazard analyses. Overall, 450 PAH patients, 308 patients with RV dilatation (201 with tetralogy of Fallot and 107 with atrial septal defects) and 67 normal controls were included. The DL algorithm achieved an accuracy and sensitivity of detecting PAH on a per patient basis of 97.6 and 100%, respectively. On univariable analysis, automatically determined right atrial area, RV area, RV fractional area change, RV inflow diameter and left ventricular eccentricity index (P &amp;lt; 0.001 for all) were significantly related to mortality. On multivariable analysis DL-based RV fractional area change (P &amp;lt; 0.001) and right atrial area (P = 0.003) emerged as independent predictors of outcome. Statistically, DL parameters were non-inferior to measures obtained manually by expert echocardiographers in predicting prognosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The study highlights the utility of DL algorithms in detecting PAH on routine echocardiograms irrespective of RV dilatation. The algorithms outperform conventional echocardiographic evaluation and provide prognostic information at expert-level. Therefore, DL methods may allow for improved screening and optimized management of PAH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jeac147","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T14:42:14Z","timestamp":1659019334000},"page":"1447-1456","source":"Crossref","is-referenced-by-count":37,"title":["A framework of deep learning networks provides expert-level accuracy for the detection and prognostication of pulmonary arterial hypertension"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3050-5248","authenticated-orcid":false,"given":"Gerhard-Paul","family":"Diller","sequence":"first","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Department of Cardiology III, Adult Congenital and Valvular Heart Disease University Hospital Muenster , Albert-Schweitzer Campus 1, Building A1, 48149 M\u00fcnster , Germany"},{"name":"Competence Network for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research) , 13353 Berlin , Germany"},{"name":"Kings College London , London WC2R 2LS , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Benesch Vidal","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Department of Cardiology III, Adult Congenital and Valvular Heart Disease University Hospital Muenster , Albert-Schweitzer Campus 1, Building A1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Kempny","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Imperial College for Science and Medicine , London SW3 6LY , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Kubota","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University , Tochigi 329-0498 , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3394-5559","authenticated-orcid":false,"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Imperial College for Science and Medicine , London SW3 6LY , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Imperial College for Science and Medicine , London SW3 6LY , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3180-7280","authenticated-orcid":false,"given":"Alexandra","family":"Arvanitaki","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Department of Cardiology III, Adult Congenital and Valvular Heart Disease University Hospital Muenster , Albert-Schweitzer Campus 1, Building A1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid E","family":"Lammers","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J","family":"Wort","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. Thomas\u2019 NHS Trust , Sydney Street, London SW3 6NP , UK"},{"name":"Imperial College for Science and Medicine , London SW3 6LY , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9542-8821","authenticated-orcid":false,"given":"Helmut","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Department of Cardiology III, Adult Congenital and Valvular Heart Disease University Hospital Muenster , Albert-Schweitzer Campus 1, Building A1, 48149 M\u00fcnster , Germany"},{"name":"Competence Network for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research) , 13353 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2836-6333","authenticated-orcid":false,"given":"Stefan","family":"Orwat","sequence":"additional","affiliation":[{"name":"Department of Cardiology III, Adult Congenital and Valvular Heart Disease University Hospital Muenster , Albert-Schweitzer Campus 1, Building A1, 48149 M\u00fcnster , Germany"},{"name":"Competence Network for Congenital Heart Defects, DZHK (German Centre for Cardiovascular Research) , 13353 Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Gatzoulis","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease and Pulmonary Hypertension, Royal Brompton Hospital, Guy\u2019s and St. 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