Digital Twins Modeling Blood Flow Could Predict Heart Problems
The HARVEY platform leverages supercomputing, physics-based simulations, and wearable device data to monitor real-time hemodynamics and spot heart failure early.
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Evaluation, Treatment, and Outcomes in Patients With Possible Severe Aortic Stenosis
Background Severe aortic stenosis (AS) is associated with significant morbidity and mortality. Prior reports suggest that severe AS is under-recognized and undertreated. Methods Retrospective analysis of the Duke Echocardiography Laboratory Database of individuals undergoing an echocardiogram between 2016 and 2024. Patients with possible severe AS (any of the following: aortic valve area (AVA) <1.0 cm2,…
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Patient-centered evaluation of anticoagulation in atrial fibrillation
BACKGROUND Prior analyses of trials comparing direct oral anticoagulants (DOACs) to warfarin in atrial fibrillation (AF) have not routinely incorporated patient preferences, despite substantial variation in how patients value the trade-off between outcomes such as stroke and bleeding. By applying patient-centered approaches, we aimed to provide intuitive metrics to inform shared decision-making, particularly for frail…
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Predictors of ischemic stroke and major bleeding among patients with atrial fibrillation in clinical practice
Background Numerous risk scores exist to quantify the risk of ischemic stroke risk in patients with atrial fibrillation or flutter (AF/AFL). However, how these tools perform in cohorts or those already on oral anticoagulation (OAC) therapy is unclear. Methods Using 2 electronic health records datasets, individuals with AF/AFL were identified (Duke University Health System [DUHS]—2009-2018;…
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Predictors of ischemic stroke and major bleeding among patients with atrial fibrillation in clinical practice
Background Numerous risk scores exist to quantify the risk of ischemic stroke risk in patients with atrial fibrillation or flutter (AF/AFL). However, how these tools perform in cohorts or those already on oral anticoagulation (OAC) therapy is unclear. Methods Using two electronic health records datasets, individuals with AF/AFL were identified [Duke University Health System (DUHS)…
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Performance of PREVENT Cardiovascular Risk in Electronic Health Record–Based Clinical Practice
Question Do the Predicting Risk of Cardiovascular Disease Events (PREVENT) equations maintain 5-year cardiovascular disease (CVD) risk performance across subgroups under electronic health record (EHR) conditions with missing data? Findings In this cohort study using data from the Duke University Health System EHR to create a cohort of 127 151 individuals with complete data and a cohort of…
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TCT-924 Association of Patient-Reported Outcomes (PROs) in Chronic Limb-Threatening Ischemia (CLTI) Patients with Baseline Clinical Characteristics and Outcomes
BACKGROUND There is an association between PROs and clinical outcomes in symptomatic patients with PAD but their role in the subset with CLTI is unknown. We evaluated the association between PROs and clinical characteristics and outcomes in patients with CLTI. METHODS We analyzed data from the BEST-CLI (Best Endovascular versus Best Surgical Therapy in Patients…
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Establishing hemodynamic convergence framework for coronary digital twins under realistic dynamic heart rates
The advent of digital twins has increased the demand for longer-duration simulations that span multiple physiological states. Digital twins have emerged as powerful tools in cardiovascular modeling, enabling patient-specific simulations of coronary blood flow for noninvasive diagnosis and treatment planning. Although these simulations achieve high fidelity under steady or periodic heart rates, modeling real-world transitions,…
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Digital twins for noninvasively measuring predictive markers of right heart failure
Digital twins offer a promising approach to advancing healthcare by providing precise, noninvasive monitoring and early detection of diseases. In heart failure (HF), a leading cause of mortality worldwide, they can improve patient monitoring and clinical outcomes by simulating hemodynamic changes indicative of worsening HF. Current techniques are limited by their invasiveness and lack of…
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A systematic quantification of hemodynamic differences persisting after aortic coarctation repair
Aortic coarctation (CoA) comprises 6%–8% of all congenital heart diseases and is the second most common cardiovascular disease requiring neonatal surgical correction. However, patients remain at high risk for long-term complications, notably recoarctation. Methods: Hemodynamic simulations were performed in a group of six patients following CoA repair, as compared to a group of age and sex-matched…
