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5. Painting the black box white: experimental findings from applying XAI to an ECG reading setting

Author

Cabitza, Federico, Cameli, Matteo, Campagner, Andrea, Natali, Chiara, and Ronzio, Luca

Subjects
Computer Science - Artificial Intelligence, I.2.1, H.5.2
Abstract

The shift from symbolic AI systems to black-box, sub-symbolic, and statistical ones has motivated a rapid increase in the interest toward explainable AI (XAI), i.e. approaches to make black-box AI systems explainable to human decision makers with the aim of making these systems more acceptable and more usable tools and supports. However, we make the point that, rather than always making black boxes transparent, these approaches are at risk of \emph{painting the black boxes white}, thus failing to provide a level of transparency that would increase the system's usability and comprehensibility; or, even, at risk of generating new errors, in what we termed the \emph{white-box paradox}. To address these usability-related issues, in this work we focus on the cognitive dimension of users' perception of explanations and XAI systems. To this aim, we designed and conducted a questionnaire-based experiment by which we involved 44 cardiology residents and specialists in an AI-supported ECG reading task. In doing so, we investigated different research questions concerning the relationship between users' characteristics (e.g. expertise) and their perception of AI and XAI systems, including their trust, the perceived explanations' quality and their tendency to defer the decision process to automation (i.e. technology dominance), as well as the mutual relationships among these different dimensions. Our findings provide a contribution to the evaluation of AI-based support systems from a Human-AI interaction-oriented perspective and lay the ground for further investigation of XAI and its effects on decision making and user experience., Comment: 15 pages, 7 figures

Published
2022

6. Echocardiographic and clinical features of patients developing prosthesis‐patient mismatch after transcatheter aortic valve replacement: Insights from the Recovery-TAVR registry

Author

Bruno, Francesco, Rampone, Joao Matteo, Islas, Fabian, Gorla, Riccardo, Gallone, Guglielmo, Melillo, Francesco, Leone, Pier Pasquale, Cimaglia, Paolo, Pastore, Maria Concetta, Franzone, Anna, Landra, Federico, Scudeler, Luca, Jimenez-Quevedo, Pilar, Viva, Tommaso, Piroli, Francesco, Bragato, Renato, Trichilo, Michele, Degiovanni, Anna, Salizzoni, Stefano, Ilardi, Federica, Andreis, Alessandro, Nombela-Franco, Luis, Tusa, Maurizio, Toselli, Marco, Conrotto, Federico, Montorfano, Matteo, Manzo, Rachele, Cameli, Matteo, Patti, Giuseppe, Stefanini, Giulio, Testa, Luca, La Torre, Michele, Giannini, Francesco, Agricola, Eustachio, Escaned, Javier, De Filippo, Ovidio, De Ferrari, Gaetano M., and D'Ascenzo, Fabrizio

Published
2024
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7. Physical exercise in hypertensive heart disease: From the differential diagnosis to the complementary role of exercise

Author

Pastore, Maria Concetta, Cavigli, Luna, Olivoni, Gabriele, Morrone, Francesco, Amati, Francesca, Imbalzano, Egidio, Rinaldi, Andrea, Liga, Riccardo, Mattioli, Anna Vittoria, Scicchitano, Pietro, Curcio, Antonio, Barillà, Francesco, Ciccarelli, Michele, Maestrini, Viviana, Perrone Filardi, Pasquale, D'Ascenzi, Flavio, and Cameli, Matteo

Published
2024
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9. Risk Score for Long-Term Survival and Major Adverse Cardiovascular and Cerebrovascular Events After Coronary Artery Bypass Grafting Surgery

Author

Dokollari, Aleksander, Rosati, Fabrizio, Muneretto, Claudio, Amabile, Andrea, Pernoci, Marjela, Gemelli, Marco, Hassanabad, Ali Fatehi, Sicouri, Serge, Sicouri, Noah, Yamashita, Yoshiyuki, Baudo, Massimo, Bonacchi, Massimo, Cabrucci, Francesco, Bacchi, Beatrice, Ghorpade, Nitin, Shah, Ashish, Coku, Lindita, Cameli, Matteo, Mandoli, Giulia Elena, Kjelstrom, Stephanie, Montone, Georgia, Wertan, Maryann, Ramlawi, Basel, DiMagli, Arnaldo, and Sutter, Francis P.

Published
2024
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10. Aortopathy and aortic valve surgery in patients with bicuspid aortic valve with and without raphe

Author

Bellino, Michele, Antonini-Canterin, Francesco, Bossone, Eduardo, Faggiano, Pompilio, Chirillo, Fabio, La Carrubba, Salvatore, Faganello, Giorgio, Cecconi, Moreno, Zito, Concetta, Dasseni, Nicolò, Nistri, Stefano, Moreo, Antonella, Fabiani, Iacopo, Faden, Giacomo, Agostini, Francesco, Manuppelli, Vincenzo, Cameli, Matteo, Cresti, Alberto, Dentamaro, Ilaria, Monte, Ines Paola, Barbieri, Andrea, Ciampi, Quirino, Giorgi, Mauro, Galasso, Gennaro, Carerj, Scipione, Pepi, Mauro, Benedetto, Frank, Colonna, Paolo, and Citro, Rodolfo

Published
2024
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12. ECG/echo indexes in the diagnostic approach to amyloid cardiomyopathy: A head-to-head comparison from the AC-TIVE study

Author

Longo, Francesca, Rossi, Maddalena, Varrà, Guerino Giuseppe, Saro, Riccardo, Dore, Franca, Girardi, Francesca, Vergaro, Giuseppe, Musumeci, Beatrice, Autore, Camillo, Cappelli, Francesco, Perfetto, Federico, Olivotto, Iacopo, Favale, Stefano, Carella, Maria Cristina, Guaricci, Andrea Igoren, Ciccone, Marco Matteo, Di Bella, Gianluca, Tomasoni, Daniela, Rella, Valeria, Branzi, Giovanna, Badano, Luigi, Parati, Gianfranco, Palmiero, Giuseppe, Caiazza, Martina, Caponetti, Angelo Giuseppe, Saturi, Giulia, Labate, Marianna Eleonora, Andreis, Alessandro, Paneva, Elena, De Ferrari, Gaetano Maria, Di Ienno, Luca, De Carli, Giuseppe, Giacomin, Elisa, Arzilli, Chiara, Pagura, Linda, Porcari, Aldostefano, Cameli, Matteo, Biagini, Elena, Canepa, Marco, Crotti, Lia, Imazio, Massimo, Forleo, Cinzia, Pavasini, Rita, Limongelli, Giuseppe, Perlini, Stefano, Metra, Marco, Boriani, Giuseppe, Emdin, Michele, Sinagra, Gianfranco, and Merlo, Marco

Published
2024
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19. Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry

Author

Benfari, Giovanni, Mandoli, Giulia Elena, Magne, Julien, Miglioranza, Marcelo Haertel, Ancona, Roberta, Luksic, Vlatka Reskovic, Pastore, Maria Concetta, Santoro, Ciro, Michalski, Blazej, Malagoli, Alessandro, Muraru, Denisa, Donal, Erwan, Cosyns, Bernard, Edvardsen, Thor, Popescu, Bogdan Alexandru, and Cameli, Matteo

Published
2022
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24. Contributors

Author

Baggish, Aaron, primary, Bossone, Eduardo, additional, Cameli, Matteo, additional, Carbone, Andreina, additional, Castelletti, Silvia, additional, Ciriello, Giovanni Domenico, additional, Correra, Anna, additional, D’Andrea, Antonello, additional, D’Ascenzi, Flavio, additional, Dweck, Marc, additional, Gambardella, Francesco, additional, La Gerche, Andre, additional, Limongelli, Giuseppe, additional, Monda, Emanuele, additional, Palermi, Stefano, additional, Papaccioli, Giovanni, additional, Papadakis, Michael, additional, Picano, Eugenio, additional, Pontone, Gianluca, additional, Russo, Vincenzo, additional, Sarubbi, Berardo, additional, Serio, Alessandro, additional, and Sperlongano, Simona, additional

Published
2023
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27. Hypertriglyceridemia: Molecular and Genetic Landscapes

Author

Scicchitano, Pietro, primary, Amati, Francesca, additional, Ciccone, Marco Matteo, additional, D’Ascenzi, Flavio, additional, Imbalzano, Egidio, additional, Liga, Riccardo, additional, Paolillo, Stefania, additional, Pastore, Maria Concetta, additional, Rinaldi, Andrea, additional, Mattioli, Anna Vittoria, additional, and Cameli, Matteo, additional

Published
2024
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28. Myocardial Work Indices Predict Hospitalization in Patients with Advanced Heart Failure

Author

Mandoli, Giulia Elena, primary, Landra, Federico, additional, Chiantini, Benedetta, additional, Bonadiman, Lorenzo, additional, Pastore, Maria Concetta, additional, Focardi, Marta, additional, D’Ascenzi, Flavio, additional, Lisi, Matteo, additional, Diviggiano, Enrico Emilio, additional, Martini, Luca, additional, Bernazzali, Sonia, additional, Valente, Serafina, additional, Maccherini, Massimo, additional, Cameli, Matteo, additional, and Henein, Michael Y., additional

Published
2024
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31. Perspectives in noninvasive imaging for chronic coronary syndromes

Author

Morrone, Doralisa, Gentile, Francesco, Aimo, Alberto, Cameli, Matteo, Barison, Andrea, Picoi, Maria Elena, Guglielmo, Marco, Villano, Angelo, DeVita, Antonio, Mandoli, Giulia Elena, Pastore, Maria Concetta, Barillà, Francesco, Mancone, Massimo, Pedrinelli, Roberto, Indolfi, Ciro, Filardi, Pasquale Perrone, Muscoli, Saverio, Tritto, Isabella, Bergamaschi, Luca, Pizzi, Carmine, Camici, Paolo G., Marzilli, Mario, Crea, Filippo, Caterina, Raffaele De, Pontone, Gianluca, Neglia, Danilo, and Lanza, Gaetano A.

Published
2022
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35. Recommendations in pre-procedural imaging assessment for TAVI intervention: SIC-SIRM position paper part 2 (CT and MR angiography, standard medical reporting, future perspectives)

Author

Marano, Riccardo, Pontone, Gianluca, Agricola, Eustachio, Alushi, Brunilda, Bartorelli, Antonio, Cameli, Matteo, Carrabba, Nazario, Esposito, Antonio, Faletti, Riccardo, Francone, Marco, Galea, Nicola, Golino, Paolo, Guglielmo, Marco, Palmisano, Anna, Petronio, Sonia, Petullà, Maria, Pradella, Silvia, Ribichini, Flavio, Romeo, Francesco, Russo, Vincenzo, Scandura, Salvatore, Schicchi, Nicolò, Spaccarotella, Carmen, Tomai, Fabrizio, Indolfi, Ciro, and Centonze, Maurizio

Published
2022
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38. Cardiac Magnetic Resonance Speckle Tracking Analysis of Right Ventricle Function in Myocarditis with Preserved Right Ventricular Ejection Fraction.

Author

Özden, Özge, Ünlü, Serkan, Şahin, Ahmet Anıl, Barutçu, Ahmet, Gövdeli, Elif Ayduk, Sherif, Sara Abou, Papadopoulos, Konstantinos, Bingöl, Gülsüm, Kılıç, Ismail Doğu, Özmen, Emre, Seçkin Göbüt, Özden, Landra, Federico, Cameli, Matteo, and Göktekin, Ömer

Abstract

Background and Objectives: Diagnosis of myocarditis remains a challenge in clinical practice; however, magnetic resonance imaging (CMRI) can ease the diagnostic approach by providing various parameters. The prevalence of right ventricular involvement in acute myocarditis is suggested to be more frequent than previously hypothesized. In this study, we sought to investigate subclinical RV involvement in patients with acute myocarditis and preserved RV ejection fraction (EF), using CMRI RV speckle-tracking imaging. Materials and Methods: CMRI of 27 patients with acute myocarditis (nine females, age 35.1 ± 12.2 y) was retrospectively analyzed. A control group consisting of CMRI images of 27 healthy individuals was included. Results: No significant differences were found regarding left ventricle (LV) and atrium dimensions. LV ejection fraction was significantly different between groups (56.6 ± 10.6 vs. 62.1 ± 2.6, p < 0.05). No significant differences were present between parameters used for conventional assessment of RV. However, RV strain absolute values were significantly lower in the acute myocarditis group in comparison with that of the control group (18.4 ± 5.4 vs. 21.8 ± 2.8, p = 0.018). Conclusions: Subclinical RV dysfunction detected by CMR-derived strain may be present in patients with acute myocarditis even with preserved RVEF. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Multimodality imaging for the evaluation and management of patients with long-term (durable) left ventricular assist devices: A clinical consensus statement of the European Association of Cardiovascular Imaging of the European Society of Cardiology.

Author

Cameli, Matteo, Aboumarie, Hatem Soliman, Pastore, Maria Concetta, Caliskan, Kadir, Cikes, Maja, Garbi, Madalina, Lim, Hoong Sern, Muraru, Denisa, Mandoli, Giulia Elena, Pergola, Valeria, Plein, Sven, Pontone, Gianluca, Soliman, Osama I, Maurovich-Horvat, Pal, Donal, Erwan, Cosyns, Bernard, Petersen, Steffen E, Antonopoulos, Alexios, Bohbot, Yohann, and Dweck, Marc

Subjects
HEART failure treatment, LEFT heart ventricle, CONSENSUS (Social sciences), DIAGNOSTIC imaging, PROSTHESIS-related infections, COMPLICATIONS of prosthesis, HEART assist devices, COMPUTED tomography, MAGNETIC resonance imaging, SURGICAL complications, ARTIFICIAL blood circulation, ECHOCARDIOGRAPHY
Abstract

Left ventricular assist devices (LVADs) are gaining increasing importance as therapeutic strategy in advanced heart failure (HF), not only as bridge to recovery or to transplant but also as destination therapy. Even though long-term LVADs are considered a precious resource to expand the treatment options and improve clinical outcome of these patients, these are limited by peri-operative and post-operative complications, such as device-related infections, haemocompatibility-related events, device mis-positioning, and right ventricular failure. For this reason, a precise pre-operative, peri-operative, and post-operative evaluation of these patients is crucial for the selection of LVAD candidates and the management LVAD recipients. The use of different imaging modalities offers important information to complete the study of patients with LVADs in each phase of their assessment, with peculiar advantages/disadvantages, ideal application, and reference parameters for each modality. This clinical consensus statement sought to guide the use of multimodality imaging for the evaluation of patients with advanced HF undergoing LVAD implantation. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Development of a Risk Score for Long-term Survival and MACCE After Coronary Artery Bypass Grafting Surgery

Author

Dokollari, Aleksander, primary, Rosati, Fabrizio, additional, Muneretto, Claudio, additional, Amabile, Andrea, additional, Pernoci, Marjela, additional, Gemelli, Marco, additional, Hassanabad, Ali Fatehi, additional, Sicouri, Serge, additional, Sicouri, Noah, additional, Yamashita, Yoshiyuki, additional, Baudo, Massimo, additional, Bonacchi, Massimo, additional, Cabrucci, Francesco, additional, Bacchi, Beatrice, additional, Ghorpade, Nitin, additional, Shah, Ashish, additional, Coku, Lindita, additional, Cameli, Matteo, additional, Mandoli, Giulia Elena, additional, Kjelstrom, Stephanie, additional, Montone, Georgia, additional, Wertan, MaryAnn, additional, Ramlawi, Basel, additional, DiMagli, Arnaldo, additional, and Sutter, Francis P., additional

Published
2024
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46. Myocardial work indices predict hospitalization in patients with advanced heart failure

Author

Mandoli, Giulia Elena, Landra, Federico, Chiantini, Benedetta, Bonadiman, Lorenzo, Pastore, Maria Concetta, Focardi, Marta, D’Ascenzi, Flavio, Lisi, Matteo, Diviggiano, Enrico Emilio, Martini, Luca, Bernazzali, Sonia, Valente, Serafina, Maccherini, Massimo, Cameli, Matteo, Henein, Michael Y., Mandoli, Giulia Elena, Landra, Federico, Chiantini, Benedetta, Bonadiman, Lorenzo, Pastore, Maria Concetta, Focardi, Marta, D’Ascenzi, Flavio, Lisi, Matteo, Diviggiano, Enrico Emilio, Martini, Luca, Bernazzali, Sonia, Valente, Serafina, Maccherini, Massimo, Cameli, Matteo, and Henein, Michael Y.

Abstract

Background: An increasing proportion of heart failure (HF) patients progress to the advanced stage (AdHF) with high event rates and limited treatment options. Echocardiography, particularly Speckle Tracking-derived myocardial work (MW), is useful for HF diagnosis and prognosis. We aimed to assess MW’s feasibility in the prognostic stratification of AdHF. Methods: We retrospectively screened patients with AdHF who accessed our hospital in 2018–2022. We excluded subjects with inadequate acoustic windows; unavailable brachial artery cuff pressure at the time of the echocardiography; atrial fibrillation; and mitral or aortic regurgitation. We measured standard parameters and left ventricular (LV) strain (LS) and MW. The population was followed up to determine the composite outcomes of all-cause mortality, left ventricular assist device implantation and heart transplantation (primary endpoint), as well as unplanned HF hospitalization (secondary endpoint). Results: We enrolled 138 patients, prevalently males (79.7%), with a median age of 58 years (IQR 50–62). AdHF etiology was predominantly non-ischemic (65.9%). Thirty-five patients developed a composite event during a median follow-up of 636 days (IQR 323–868). Diastolic function, pulmonary pressures, and LV GLS and LV MW indices were not associated with major events. Contrarily, for the secondary endpoint, the hazard ratio for each increase in global work index (GWI) by 50 mmHg% was 0.90 (p = 0.025) and for each increase in global constructive work (GCW) by 50 mmHg% was 0.90 (p = 0.022). Kaplan–Meier demonstrated better endpoint-free survival, with an LV GWI ≥ 369 mmHg%. Conclusions: GWI and GCW, with good feasibility, can help in the better characterization of patients with AdHF at higher risk of HF hospitalization and adverse events, identifying the need for closer follow-up or additional HF therapy.

Published
2024
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47. Survival in acute heart failure in intensive cardiac care unit: a prospective study

Author

Sciaccaluga, Carlotta, Mandoli, Giulia Elena, Nannelli, Chiara, Falciani, Francesca, Rizzo, Cosimo, Sisti, Nicolò, Carrucola, Chiara, Vigna, Mariangela, Gioia, Margherita Ilaria, Incampo, Eufemia, Parisella, Maria Luisa, De Vivo, Oreste, Contorni, Francesco, Stricagnoli, Mario, Pagliaro, Antonio, D’Errico, Antonio, Donati, Giovanni, D’Ascenzi, Flavio, Valente, Serafina, Mondillo, Sergio, and Cameli, Matteo

Published
2021
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48. OPTImal PHARMacological therapy for patients with heart failure: Rationale and design of the OPTIPHARM‐HF registry.

Author

Inciardi, Riccardo M., Vaduganathan, Muthiah, Lombardi, Carlo M., Gussago, Cristina, Agostoni, Piergiuseppe, Ameri, Pietro, Aspromonte, Nadia, Calò, Leonardo, Cameli, Matteo, Carluccio, Erberto, Carugo, Stefano, Cipriani, Manlio, De Caterina, Raffaele, De Ferrari, Gaetano M., Emdin, Michele, Fornaro, Alessandra, Guazzi, Marco, Iacoviello, Massimo, Imazio, Massimo, and La Rovere, Maria Teresa

Subjects
HEART failure patients, MEDICAL prescriptions, VENTRICULAR ejection fraction, DESIGN failures, HEART failure
Abstract

Aims: Patients with heart failure (HF) remain often undertreated for multiple reasons, including treatment inertia, contraindications, and intolerance. The OPTIimal PHARMacological therapy for patients with Heart Failure (OPTIPHARM‐HF) registry is designed to evaluate the prevalence of evidence‐based medical treatment prescription and titration, as well as the causes of its underuse, in a broad real‐world population of consecutive patients with HF across the whole ejection fraction spectrum and among different clinical phenotypes. Methods: The OPTIPHARM‐HF registry (NCT06192524) is a prospective, multicenter, observational, national study of adult patients with symptomatic HF, as defined by current international guidelines, regardless of ejection fraction. Both outpatients and inpatients with chronic and acute decompensated HF will be recruited. The study will enroll up to 2500 patients with chronic HF at approximately 35 Italian HF centres. Patients will be followed for a maximum duration of 24 months. The primary objective of the OPTIPHARM‐HF registry is to assess prescription and adherence to evidence‐based guideline‐directed medical therapy (GDMT) in patients with HF. The primary outcome is to describe the prevalence of GDMT use according to target guideline recommendation. Secondary objectives include implementation of comorbidity treatment, evaluation of sequence of treatment introduction and up‐titration, description of GDMT implementation in the specific HF population, main causes of GDMT underuse, and assessment of cumulative rate of cardiovascular events. Conclusion: The OPTIPHARM‐HF registry will provide important implications for improving patient care and adoption of recommended medical therapy into clinical practice among HF patients. [ABSTRACT FROM AUTHOR]

Published
2024
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49. The Role of Speckle Tracking Echocardiography in the Evaluation of Advanced-Heart-Failure Patients.

Author

Martini, Luca, Lisi, Matteo, Pastore, Maria Concetta, Righini, Francesca Maria, Rubboli, Andrea, Henein, Michael Y., and Cameli, Matteo

Subjects
SPECKLE tracking echocardiography, ECHOCARDIOGRAPHY, SYMPTOMS, CARDIAC catheterization, OXYGEN consumption, HEART failure
Abstract

Health care is currently showing a fall in heart failure (HF) incidence and prevalence, particularly in developed countries, but with only a subset receiving appropriate therapy to protect the heart against maladaptive processes such as fibrosis and hypertrophy. Appropriate markers of advanced HF remain unidentified, which would help in choosing the most suitable therapy and avoid major compliance problems. Speckle tracking echocardiography (STE) is a good choice, being a non-invasive imaging technique which is able to assess cardiac deformation in a variety of conditions. Several multicenter studies and meta-analyses have demonstrated the clinical application and accuracy of STE in early and late stages of HF, as well as its association with both left ventricular (LV) filling pressures and myocardial oxygen consumption. Furthermore, STE assists in assessing right ventricular free-wall longitudinal strain (RVFWLS), which is a solid predictor of right ventricle failure (RVF) following LV assist device (LVAD) implantation. However, STE is known for its limitations; despite these, it has been shown to explain symptoms and signs and also to be an accurate prognosticator. The aim of this review is to examine the advantages of STE in the early evaluation of myocardial dysfunction and its correlation with right heart catheterization (RHC) parameters, which should have significant clinical relevance in the management of HF patients. [ABSTRACT FROM AUTHOR]

Published
2024
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