title: Artificial intelligence in mitral valve analysis.
abstract: BACKGROUND
  Echocardiographic analysis of mitral valve (MV) has become essential for diagnosis and management of patients with MV disease. Currently, the various software used for MV analysis require manual input and are prone to interobserver variability in the measurements.
  
  
  OBJECTIVE
  The aim of this study is to determine the interobserver variability in an automated software that uses artificial intelligence for MV analysis.
  
  
  METHODS
  Retrospective analysis of intraoperative three-dimensional transesophageal echocardiography data acquired from four patients with normal MV undergoing coronary artery bypass graft surgery in a tertiary hospital.
  
  
  METHODS
  Echocardiographic data were analyzed using the eSie Valve Software (Siemens Healthcare, Mountain View, CA, USA). Three examiners analyzed three end-systolic (ES) frames from each of the four patients. A total of 36 ES frames were analyzed and included in the study.
  
  
  METHODS
  A multiple mixed-effects ANOVA model was constructed to determine if the examiner, the patient, and the loop had a significant effect on the average value of each parameter. A Bonferroni correction was used to correct for multiple comparisons, and P = 0.0083 was considered to be significant.
  
  
  RESULTS
  Examiners did not have an effect on any of the six parameters tested. Patient and loop had an effect on the average parameter value for each of the six parameters as expected (P < 0.0083 for both).
  
  
  CONCLUSIONS
  We were able to conclude that using automated analysis, it is possible to obtain results with good reproducibility, which only requires minimal user intervention.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Jelliffe
authors.initials: J
authors.lastname: Jeganathan
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Ziyad
authors.initials: Z
authors.lastname: Knio
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Hospital México, University of Costa Rica, San José, Costa Rica.
authors.forename: Yannis
authors.initials: Y
authors.lastname: Amador
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Peking University People's Hospital, Beijing, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Hai
authors.affiliation: Department of Cardio-Thoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Arash
authors.initials: A
authors.lastname: Khamooshian
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Robina
authors.initials: R
authors.lastname: Matyal
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Kamal R
authors.initials: KR
authors.lastname: Khabbaz
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Feroze
authors.initials: F
authors.lastname: Mahmood
mesh_terms: D001185:Artificial Intelligence; D001026:Coronary Artery Bypass; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies