Expert consensus document on artificial intelligence of the Italian Society of Cardiology.

Journal: Journal of cardiovascular medicine (Hagerstown, Md.)
PMID:

Abstract

Artificial intelligence (AI), a branch of computer science focused on developing algorithms that replicate intelligent behaviour, has recently been used in patients management by enhancing diagnostic and prognostic capabilities of various resources such as hospital datasets, electrocardiograms and echocardiographic acquisitions. Machine learning (ML) and deep learning (DL) models, both key subsets of AI, have demonstrated robust applications across several cardiovascular diseases, from the most diffuse like hypertension and ischemic heart disease to the rare infiltrative cardiomyopathies, as well as to estimation of LDL cholesterol which can be achieved with better accuracy through AI. Additional emerging applications are encountered when unsupervised ML methodology shows promising results in identifying distinct clusters or phenotypes of patients with atrial fibrillation that may have different risks of stroke and response to therapy. Interestingly, since ML techniques do not analyse the possibility that a specific pathology can occur but rather the trajectory of each subject and the chain of events that lead to the occurrence of various cardiovascular pathologies, it has been considered that DL, by resembling the complexity of human brain and using artificial neural networks, might support clinical management through the processing of large amounts of complex information; however, external validity of algorithms cannot be taken for granted, while interpretability of the results may be an issue, also known as a "black box" problem. Notwithstanding these considerations, facilities and governments are willing to unlock the potential of AI in order to reach the final step of healthcare advancements while ensuring that patient safety and equity are preserved.

Authors

  • Ciro Indolfi
    Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende.
  • Piergiuseppe Agostoni
    Centro Cardiologico MonzinoScientific Institute for Research, Hospitalisation and Health Care (IRCCS)MilanItaly; Cardiovascular Section, Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly.
  • Francesco Barillà
    Department of Systems Medicine, University of Rome 'Tor Vergata'.
  • Andrea Barison
    Cardiology and Cardiovascular Medicine, Fondazione Toscana Gabriele Monasterio, Pisa.
  • Stefano Benenati
    Department of Internal Medicine, University of Genoa.
  • Grzegorz Bilo
    Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan.
  • Giuseppe Boriani
  • Natale Daniele Brunetti
    Department of Medical and Surgical Sciences, University of Foggia, Via Antonio Gramsci, 89, 71122 Foggia, Italy.
  • Paolo Calabrò
    Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli', Caserta.
  • Stefano Carugo
    Department of Cardio-Thoracic-Vascular Area, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan.
  • Michela Casella
    Cardiology and Arrhythmology Clinic, University Hospital 'Azienda Ospedaliero-Universitaria delle Marche', Ancona.
  • Michele Ciccarelli
    Department of Medicine, Surgery and Dentistry, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, Salerno, Italy.
  • Marco Matteo Ciccone
    Department of Emergency and Organ Transplantation, School of Cardiology, University of Bari, Bari, Italy.
  • Gaetano Maria De Ferrari
    Division of Cardiology, University of Turin, Turin.
  • Gianluigi Greco
    Department of Mathematics and Computer Science, University of Calabria, Rend.
  • Giovanni Esposito
    CEINGE Biotechnology Center, 80131 Naples, Italy.
  • Emanuela T Locati
    Department of Arrhythmology and Electrophysiology, IRCCS Policlinico San Donato, Milan.
  • Andrea Mariani
    Department of Advanced Biomedical Sciences, Federico II University, Naples.
  • Marco Merlo
    Center for Cardiomyopathies, Cardiothoracovascular Dept, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste.
  • Saverio Muscoli
    Division of Cardiology, Policlinico Tor Vergata, University of Rome.
  • Savina Nodari
    Division of Cardiology, Day Hospital service, University of Brescia, Brescia.
  • Iacopo Olivotto
    Division of Cardiology, University of Florence, Florence.
  • Stefania Paolillo
    Department of Advanced Biomedical Sciences, Federico II University, Naples.
  • Alberto Polimeni
    Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende.
  • Aldostefano Porcari
    Center for Cardiomyopathies, Cardiothoracovascular Dept, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste.
  • Italo Porto
    Cardiology Unit, Department of Cardiothoracic and Vascular Surgery (DICATOV), San Martino Hospital, Genoa.
  • Carmen Spaccarotella
    Department of Advanced Biomedical Sciences, Federico II University, Naples.
  • Carmine Dario Vizza
    Pulmonary Hypertension Unit, Department of Cardiovascular and Respiratory Disease, La Sapienza University of Rome, Rome, Italy.
  • Nicola Leone
    Department of Mathematics and Computer Science, University of Calabria, Rend.
  • Gianfranco Sinagra
    1 Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy.
  • Pasquale Perrone Filardi
    Department of Advanced Biomedical Sciences, Federico II University, Naples.
  • Antonio Curcio
    Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende.