Pulmonary hypertension (PH) in newborns is a critical condition characterized by elevated pressure in the pulmonary arteries, leading to right ventricular strain and heart failure. While right heart catheterization (RHC) is the diagnostic gold standard, echocardiography is preferred due to its non-invasive nature, safety, and accessibility. However, its accuracy highly depends on the operator, making PH assessment subjective. While automated detection methods have been explored, most models focus on adults and rely on single-view echocardiographic frames, limiting their performance in diagnosing PH in newborns. While multi-view echocardiography has shown promise in improving PH assessment, existing models struggle with generalizability. In this work, we employ a multi-view variational autoencoder (VAE) for PH prediction using echocardiographic videos. By leveraging the VAE framework, our model captures complex latent representations, improving feature extraction and robustness. We compare its performance against single-view and supervised learning approaches. Our results show improved generalization and classification accuracy, highlighting the effectiveness of multi-view learning for robust PH assessment in newborns.

Early and accurate diagnosis of pulmonary hypertension (PH) is essential for optimal patient management. Differentiating between pre-capillary and post-capillary PH is critical for guiding treatment decisions. This study develops and validates a deep learning-based diagnostic model for PH, designed to classify patients as non-PH, pre-capillary PH, or post-capillary PH. This retrospective study analyzed data from 204 patients (112 with pre-capillary PH, 32 with post-capillary PH, and 60 non-PH controls) at the First Affiliated Hospital of Nanjing Medical University. Diagnoses were confirmed through right heart catheterization. We selected 6 samples from each category for the test set (18 samples, 10%), with the remaining 186 samples used for the training set. This process was repeated 35 times for testing. This paper proposes a deep learning model that combines Graph convolutional networks (GCN), Convolutional neural networks (CNN), and Transformers. The model was developed to process multimodal data, including short-axis (SAX) sequences, four-chamber (4CH) sequences, and clinical parameters. Our model achieved a performance of Area under the receiver operating characteristic curve (AUC) = 0.81 +- 0.06(standard deviation) and Accuracy (ACC) = 0.73 +- 0.06 on the test set. The discriminative abilities were as follows: non-PH subjects (AUC = 0.74 +- 0.11), pre-capillary PH (AUC = 0.86 +- 0.06), and post-capillary PH (AUC = 0.83 +- 0.10). It has the potential to support clinical decision-making by effectively integrating multimodal data to assist physicians in making accurate and timely diagnoses.

SUMMARY Microvascular disease is a contributor to persistent pulmonary hypertension in those with chronic thromboembolic pulmonary hypertension (CTEPH). The heterogenous nature of the micro and macrovascular defects motivates the use of personalized computational models, which can predict flow dynamics within multiple generations of the arterial tree and into the microvasculature. Our study uses computational hemodynamics models and Gaussian processes for rapid, subject-specific calibration using retrospective data from a large animal model of CTEPH. Our subject-specific predictions shed light on microvascular dysfunction and arterial wall shear stress changes in CTEPH. Key words: 1D fluid dynamics, gaussian processes, parameter inference, emulation 1 INTRODUCTION Chronic thromboembolic pulmonary hypertension (CTEPH) is a subgroup of pulmonary hypertension (PH) caused by blood clots that lodge in the blood vessels of the lungs.

Pulmonary Hypertension (PH) is a severe disease characterized by an elevated pulmonary artery pressure. The gold standard for PH diagnosis is measurement of mean Pulmonary Artery Pressure (mPAP) during an invasive Right Heart Catheterization. In this paper, we investigate noninvasive approach to PH detection utilizing Magnetic Resonance Imaging, Computer Models and Machine Learning. We show using the ablation study, that physics-informed feature engineering based on models of blood circulation increases the performance of Gradient Boosting Decision Trees-based algorithms for classification of PH and regression of values of mPAP. We compare results of regression (with thresholding of estimated mPAP) and classification and demonstrate that metrics achieved in both experiments are comparable. The predicted mPAP values are more informative to the physicians than the probability of PH returned by classification models. They provide the intuitive explanation of the outcome of the machine learning model (clinicians are accustomed to the mPAP metric, contrary to the PH probability).

Identifying disease phenotypes from electronic health records (EHRs) is critical for numerous secondary uses. Manually encoding physician knowledge into rules is particularly challenging for rare diseases due to inadequate EHR coding, necessitating review of clinical notes. Large language models (LLMs) offer promise in text understanding but may not efficiently handle real-world clinical documentation. We propose a zero-shot LLM-based method enriched by retrieval-augmented generation and MapReduce, which pre-identifies disease-related text snippets to be used in parallel as queries for the LLM to establish diagnosis. We show that this method as applied to pulmonary hypertension (PH), a rare disease characterized by elevated arterial pressures in the lungs, significantly outperforms physician logic rules ($F_1$ score of 0.62 vs. 0.75). This method has the potential to enhance rare disease cohort identification, expanding the scope of robust clinical research and care gap identification.

Pulmonary hypertension (PH) is a condition of high blood pressure that affects the arteries in the lungs and the right side of the heart (Mayo Clinic, 2017). A mean pulmonary artery pressure greater than 25 mmHg is defined as Pulmonary hypertension. The estimated 5-year survival rate from the time of diagnosis of pulmonary hypertension is only 57% without therapy and patients with right heart failure only survive for approximately 1 year without treatment (Benza et al., 2012). Given the indolent nature of the disease, early detection of PH remains a challenge leading to delays in therapy. Echocardiography is currently used as a screening tool for diagnosing PH. However, electrocardiography (ECG), a more accessible, simple to use, and cost-effective tool compared to echocardiography, is less studied and explored for screening at-risk patients for PH. The goal of this project is to create a neural network model which can process an ECG signal and detect the presence of PH with a confidence probability. I created a dense neural network (DNN) model that has an accuracy of 98% over the available training sample. For future steps, the current model will be updated with a model suited for time-series data. To balance the dataset with proper training samples, I will generate additional data using data augmentation techniques. Through early and accurate detection of conditions such as PH, we widen the spectrum of innovation in detecting chronic life-threatening health conditions and reduce associated mortality and morbidity.

Purpose: Lung disease assessment in precapillary pulmonary hypertension (PH) is essential for appropriate patient management. This study aims to develop an artificial intelligence (AI) deep learning model for lung texture classification in CT Pulmonary Angiography (CTPA), and evaluate its correlation with clinical assessment methods. Materials and Methods: In this retrospective study with external validation, 122 patients with pre-capillary PH were used to train (n=83), validate (n=17) and test (n=10 internal test, n=12 external test) a patch based DenseNet-121 classification model. "Normal", "Ground glass", "Ground glass with reticulation", "Honeycombing", and "Emphysema" were classified as per the Fleishner Society glossary of terms. Ground truth classes were segmented by two radiologists with patches extracted from the labelled regions. Proportion of lung volume for each texture was calculated by classifying patches throughout the entire lung volume to generate a coarse texture classification mapping throughout the lung parenchyma. AI output was assessed against diffusing capacity of carbon monoxide (DLCO) and specialist radiologist reported disease severity. Results: Micro-average AUCs for the validation, internal test, and external test were 0.92, 0.95, and 0.94, respectively. The model had consistent performance across parenchymal textures, demonstrated strong correlation with diffusing capacity of carbon monoxide (DLCO), and showed good correspondence with disease severity reported by specialist radiologists. Conclusion: The classification model demonstrates excellent performance on external validation. The clinical utility of its output has been demonstrated. This objective, repeatable measure of disease severity can aid in patient management in adjunct to radiological reporting.

Electronic health records (EHR) often contain sensitive medical information about individual patients, posing significant limitations to sharing or releasing EHR data for downstream learning and inferential tasks. We use normalizing flows (NF), a family of deep generative models, to estimate the probability density of a dataset with differential privacy (DP) guarantees, from which privacy-preserving synthetic data are generated. We apply the technique to an EHR dataset containing patients with pulmonary hypertension. We assess the learning and inferential utility of the synthetic data by comparing the accuracy in the prediction of the hypertension status and variational posterior distribution of the parameters of a physics-based model. In addition, we use a simulated dataset from a nonlinear model to compare the results from variational inference (VI) based on privacy-preserving synthetic data, and privacy-preserving VI obtained from directly privatizing NFs for VI with DP guarantees given the original non-private dataset. The results suggest that synthetic data generated through differentially private density estimation with NF can yield good utility at a reasonable privacy cost. We also show that VI obtained from differentially private NF based on the free energy bound loss may produce variational approximations with significantly altered correlation structure, and loss formulations based on alternative dissimilarity metrics between two distributions might provide improved results.

AI could also have a transformative effect on clinical decision-making through the utilisation of the huge levels of genomic, biomarker, phenotype, behavioural, biographical and clinical data that is generated across the health system. Bayer and Merck & Co provide a perfect example of this. They have developed an AI software system to support clinical decision-making of chronic thromboembolic pulmonary hypertension (CTEPH) – a rare form of pulmonary hypertension. The software helps differentiate patients from those suffering with similar symptoms that are actually a result of asthma and chronic obstructive pulmonary disease (COPD), and therefore diagnose CTEPH more reliably and efficiently. The CTEPH Pattern Recognition Artificial Intelligence obtained FDA Breakthrough Device Designation in December 2018.

By leveraging Data Science, AI, and other digital technologies, the healthcare industry could build complementary health solutions that are personalized to the specific needs of patients. Here is how and why. The world population grows by more than 80 million per year, according to a 2017 report by the United Nations. By 2050, there will be 10 billion people on this planet and people over the age of 60 years and above are expected to double. It's clear that a growing and aging world population needs better and more sustainable solutions for health and nutrition.