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Khanna NN, Maindarkar M, Puvvula A, Paul S, Bhagawati M, Ahluwalia P, Ruzsa Z, Sharma A, Munjral S, Kolluri R, Krishnan PR, Singh IM, Laird JR, Fatemi M, Alizad A, Dhanjil SK, Saba L, Balestrieri A, Faa G, Paraskevas KI, Misra DP, Agarwal V, Sharma A, Teji J, Al-Maini M, Nicolaides A, Rathore V, Naidu S, Liblik K, Johri AM, Turk M, Sobel DW, Pareek G, Miner M, Viskovic K, Tsoulfas G, Protogerou AD, Mavrogeni S, Kitas GD, Fouda MM, Kalra MK, Suri JS. Vascular Implications of COVID-19: Role of Radiological Imaging, Artificial Intelligence, and Tissue Characterization: A Special Report. J Cardiovasc Dev Dis 2022; 9:jcdd9080268. [PMID: 36005433 PMCID: PMC9409845 DOI: 10.3390/jcdd9080268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/30/2022] [Accepted: 08/09/2022] [Indexed: 12/15/2022] Open
Abstract
The SARS-CoV-2 virus has caused a pandemic, infecting nearly 80 million people worldwide, with mortality exceeding six million. The average survival span is just 14 days from the time the symptoms become aggressive. The present study delineates the deep-driven vascular damage in the pulmonary, renal, coronary, and carotid vessels due to SARS-CoV-2. This special report addresses an important gap in the literature in understanding (i) the pathophysiology of vascular damage and the role of medical imaging in the visualization of the damage caused by SARS-CoV-2, and (ii) further understanding the severity of COVID-19 using artificial intelligence (AI)-based tissue characterization (TC). PRISMA was used to select 296 studies for AI-based TC. Radiological imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound were selected for imaging of the vasculature infected by COVID-19. Four kinds of hypotheses are presented for showing the vascular damage in radiological images due to COVID-19. Three kinds of AI models, namely, machine learning, deep learning, and transfer learning, are used for TC. Further, the study presents recommendations for improving AI-based architectures for vascular studies. We conclude that the process of vascular damage due to COVID-19 has similarities across vessel types, even though it results in multi-organ dysfunction. Although the mortality rate is ~2% of those infected, the long-term effect of COVID-19 needs monitoring to avoid deaths. AI seems to be penetrating the health care industry at warp speed, and we expect to see an emerging role in patient care, reduce the mortality and morbidity rate.
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Affiliation(s)
- Narendra N. Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi 110001, India
| | - Mahesh Maindarkar
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
- Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India
| | - Anudeep Puvvula
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
- Annu’s Hospitals for Skin and Diabetes, Nellore 524101, India
| | - Sudip Paul
- Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India
| | - Mrinalini Bhagawati
- Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India
| | - Puneet Ahluwalia
- Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi 110017, India
| | - Zoltan Ruzsa
- Invasive Cardiology Division, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA 22904, USA
| | - Smiksha Munjral
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
| | - Raghu Kolluri
- Ohio Health Heart and Vascular, Columbus, OH 43214, USA
| | | | - Inder M. Singh
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
| | - John R. Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA 94574, USA
| | - Mostafa Fatemi
- Department of Physiology & Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
| | - Azra Alizad
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
| | - Surinder K. Dhanjil
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria, 40138 Cagliari, Italy
| | - Antonella Balestrieri
- Cardiovascular Prevention and Research Unit, Department of Pathophysiology, National & Kapodistrian University of Athens, 15772 Athens, Greece
| | - Gavino Faa
- Department of Pathology, Azienda Ospedaliero Universitaria, 09124 Cagliari, Italy
| | | | - Durga Prasanna Misra
- Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Vikas Agarwal
- Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Aman Sharma
- Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
| | - Jagjit Teji
- Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
| | - Mustafa Al-Maini
- Allergy, Clinical Immunology and Rheumatology Institute, Toronto, ON L4Z 4C4, Canada
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre and University of Nicosia Medical School, 2408 Nicosia, Cyprus
| | - Vijay Rathore
- Nephrology Department, Kaiser Permanente, Sacramento, CA 95119, USA
| | - Subbaram Naidu
- Electrical Engineering Department, University of Minnesota, Duluth, MN 55812, USA
| | - Kiera Liblik
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Amer M. Johri
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Monika Turk
- The Hanse-Wissenschaftskolleg Institute for Advanced Study, 27753 Delmenhorst, Germany
| | - David W. Sobel
- Rheumatology Unit, National Kapodistrian University of Athens, 15772 Athens, Greece
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, RI 02912, USA
| | - Martin Miner
- Men’s Health Centre, Miriam Hospital Providence, Providence, RI 02906, USA
| | - Klaudija Viskovic
- Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, 10000 Zagreb, Croatia
| | - George Tsoulfas
- Department of Surgery, Aristoteleion University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Athanasios D. Protogerou
- Cardiovascular Prevention and Research Unit, Department of Pathophysiology, National & Kapodistrian University of Athens, 15772 Athens, Greece
| | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Centre, 17674 Athens, Greece
| | - George D. Kitas
- Academic Affairs, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, UK
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester M13 9PL, UK
| | - Mostafa M. Fouda
- Department of Electrical and Computer Engineering, Idaho State University, Pocatello, ID 83209, USA
| | - Manudeep K. Kalra
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
| | - Jasjit S. Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA
- Correspondence: ; Tel.: +1-916-749-5628
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Munjral S, Ahluwalia P, Jamthikar AD, Puvvula A, Saba L, Faa G, Singh IM, Chadha PS, Turk M, Johri AM, Khanna NN, Viskovic K, Mavrogeni S, Laird JR, Pareek G, Miner M, Sobel DW, Balestrieri A, Sfikakis PP, Tsoulfas G, Protogerou A, Misra P, Agarwal V, Kitas GD, Kolluri R, Teji J, Al-Maini M, Dhanjil SK, Sockalingam M, Saxena A, Sharma A, Rathore V, Fatemi M, Alizad A, Viswanathan V, Krishnan PK, Omerzu T, Naidu S, Nicolaides A, Suri JS. Nutrition, atherosclerosis, arterial imaging, cardiovascular risk stratification, and manifestations in COVID-19 framework: a narrative review. FRONT BIOSCI-LANDMRK 2021; 26:1312-1339. [PMID: 34856770 DOI: 10.52586/5026] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023]
Abstract
Background: Atherosclerosis is the primary cause of the cardiovascular disease (CVD). Several risk factors lead to atherosclerosis, and altered nutrition is one among those. Nutrition has been ignored quite often in the process of CVD risk assessment. Altered nutrition along with carotid ultrasound imaging-driven atherosclerotic plaque features can help in understanding and banishing the problems associated with the late diagnosis of CVD. Artificial intelligence (AI) is another promisingly adopted technology for CVD risk assessment and management. Therefore, we hypothesize that the risk of atherosclerotic CVD can be accurately monitored using carotid ultrasound imaging, predicted using AI-based algorithms, and reduced with the help of proper nutrition. Layout: The review presents a pathophysiological link between nutrition and atherosclerosis by gaining a deep insight into the processes involved at each stage of plaque development. After targeting the causes and finding out results by low-cost, user-friendly, ultrasound-based arterial imaging, it is important to (i) stratify the risks and (ii) monitor them by measuring plaque burden and computing risk score as part of the preventive framework. Artificial intelligence (AI)-based strategies are used to provide efficient CVD risk assessments. Finally, the review presents the role of AI for CVD risk assessment during COVID-19. Conclusions: By studying the mechanism of low-density lipoprotein formation, saturated and trans fat, and other dietary components that lead to plaque formation, we demonstrate the use of CVD risk assessment due to nutrition and atherosclerosis disease formation during normal and COVID times. Further, nutrition if included, as a part of the associated risk factors can benefit from atherosclerotic disease progression and its management using AI-based CVD risk assessment.
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Affiliation(s)
- Smiksha Munjral
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, CA 95678, USA
| | - Puneet Ahluwalia
- Max Institute of Cancer Care, Max Superspeciality Hospital, 110058 New Delhi, India
| | - Ankush D Jamthikar
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, CA 95678, USA.,Visvesvaraya National Institute of Technology, 440001 Nagpur, India
| | - Anudeep Puvvula
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, CA 95678, USA.,Annu's Hospitals for Skin and Diabetes, 24002 Nellore, AP, India
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria, 09125 Cagliari, Italy
| | - Gavino Faa
- Department of Pathology, AOU of Cagliari, 09125 Cagliari, Italy
| | - Inder M Singh
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, CA 95678, USA
| | - Paramjit S Chadha
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, CA 95678, USA
| | - Monika Turk
- The Hanse-Wissenschaftskolleg Institute for Advanced Study, 27749 Delmenhorst, Germany
| | - Amer M Johri
- Department of Medicine, Division of Cardiology, Queen's University, Kingston, ON K7L, Canada
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, 110001 New Delhi, India
| | | | - Sophie Mavrogeni
- Cardiology Clinic, Onassis Cardiac Surgery Center, 106 71 Athens, Greece
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA 94574, USA
| | - Gyan Pareek
- Minimally Invasive Urology Institute, Brown University, Providence, RI 02906, USA
| | - Martin Miner
- Men's Health Center, Miriam Hospital Providence, RI 02903, USA
| | - David W Sobel
- Minimally Invasive Urology Institute, Brown University, Providence, RI 02906, USA
| | | | - Petros P Sfikakis
- Rheumatology Unit, National Kapodistrian University of Athens, 106 71 Athens, Greece
| | - George Tsoulfas
- Aristoteleion University of Thessaloniki, 546 30 Thessaloniki, Greece
| | | | - Prasanna Misra
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226018 Lucknow, UP, India
| | - Vikas Agarwal
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, 226018 Lucknow, UP, India
| | - George D Kitas
- Academic Affairs, Dudley Group NHS Foundation Trust, DY2 8 Dudley, UK.,Arthritis Research UK Epidemiology Unit, Manchester University, M13 9 Manchester, UK
| | | | - Jagjit Teji
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60629, USA
| | - Mustafa Al-Maini
- Allergy, Clinical Immunology and Rheumatology Institute, Toronto, ON M5H, Canada
| | - Surinder K Dhanjil
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, CA 95678, USA
| | | | - Ajit Saxena
- Department of Cardiology, Indraprastha APOLLO Hospitals, 110001 New Delhi, India
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA 22903, USA
| | - Vijay Rathore
- Nephrology Department, Kaiser Permanente, Sacramento, CA 95823, USA
| | - Mostafa Fatemi
- Department of Physiology & Biomedical Engg., Mayo Clinic College of Medicine and Science, MN 55441, USA
| | - Azra Alizad
- Department of Radiology, Mayo Clinic College of Medicine and Science, MN 55441, USA
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Professor MVD Research Centre, 600003 Chennai, India
| | - P K Krishnan
- Neurology Department, Fortis Hospital, 562123 Bangalore, India
| | - Tomaz Omerzu
- Department of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia
| | - Subbaram Naidu
- Electrical Engineering Department, University of Minnesota, Duluth, MN 55812, USA
| | - Andrew Nicolaides
- Vascular Screening and Diagnostic Centre, University of Nicosia Medical School, 999058 Nicosia, Cyprus
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPointTM, Roseville, CA 95678, USA
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