Early myocardial infarction detection over multi-view echocardiography

Abstract

Myocardial infarction (MI) is the leading cause of mortality in the world. Its early diagnosis can mitigate the extent of myocardial damage by facilitating early therapeutic interventions. The regional wall motion abnormality (RWMA) of the ischemic myocardial segments is the earliest change to set in that can be captured by echocardiography. However, assessing the motion only from a single echocardiography view may lead to missing the diagnosis of MI as the RWMA may not be visible on that specific view. Therefore, in this study, we propose to fuse apical 4-chamber (A4C) and apical 2-chamber (A2C) views in which a total of 12 myocardial segments can be analyzed for MI detection. The proposed method first estimates the motion of the left ventricle wall by Active Polynomials (APs), which extract and track the endocardial boundary to compute myocardial segment displacements. The features are extracted from the displacements, which are concatenated and fed into the classifiers to detect MI. The main contributions of this study are (1) creation of a new benchmark dataset by including both A4C and A2C views in a total of 260 echocardiography recordings, which is publicly shared with the research community, (2) improving the performance of the prior work of threshold-based APs by a machine learning based approach, and (3) a pioneer MI detection approach via multi-view echocardiography by fusing the information of A4C and A2C views. The proposed method achieves 90.91% sensitivity and 86.36% precision for MI detection over multi-view echocardiography. The software implementation is shared at https://github.com/degerliaysen/MultiEchoAI.