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4. Low- or standard-dose edoxaban versus antiplatelet therapy for leaflet thrombus and cerebral thromboembolism after TAVR: A prespecified analysis of randomized ADAPT-TAVR trial

Author

Kim, Mijin, Ahn, Jung-Min, Kang, Do-Yoon, Kim, Min-Ju, Kim, Kyung Won, Koo, Hyun Jung, Yang, Dong Hyun, Jung, Seung Chai, Kim, Byungjun, Wong, Yiu Tung Anthony, Lam, Cheung Chi Simon, Yin, Wei‐Hsian, Wei, Jeng, Lee, Yung-Tsai, Kao, Hsien-Li, Lin, Mao-Shin, Yu Ko, Tsung, Kim, Won-Jang, Kang, Se Hun, Lee, Seung-Ah, Ko, Euihong, Kim, Dae-Hee, Kang, Joon-Won, Lee, Jae-Hong, Lee, Jinho, Park, Jinsun, Kim, Hoyun, Choi, Yeonwoo, Park, Seung-Jung, and Park, Duk-Woo

Published
2024
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6. Frequency, Predictors, and Clinical Impact of Valvular and Perivalvular Thrombus After Transcatheter Aortic Valve Replacement

Author

Choi, Yeonwoo, Ahn, Jung-Min, Kang, Do-Yoon, Kim, Hwa Jung, Kim, Hoyun, Lee, Jinho, Kim, Mijin, Park, Jinsun, Kim, Kyung Won, Koo, Hyun Jung, Yang, Dong Hyun, Jung, Seung Chai, Kim, Byungjun, Anthony Wong, Yiu Tung, Simon Lam, Cheung Chi, Yin, Wei-Hsian, Wei, Jeng, Lee, Yung-Tsai, Kao, Hsien-Li, Lin, Mao-Shin, Ko, Tsung-Yu, Kim, Won-Jang, Kang, Se Hun, Lee, Seung-Ah, Kim, Dae-Hee, Lee, Jae-Hong, Park, Seung-Jung, and Park, Duk-Woo

Published
2023
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7. Effect of Edoxaban Versus Antiplatelet Therapy on Leaflet Thrombosis and Cerebral Thromboembolism After TAVI According to Major Clinical and Anatomic Factors in Prespecified Subgroup Analysis from the ADAPT-TAVR Trial

Author

Lee, Jeen Hwa, Ahn, Jung-Min, Kang, Do-Yoon, Kim, Kyung Won, Koo, Hyun Jung, Yang, Dong Hyun, Jung, Seung Chai, Kim, Byungjun, Wong, Yiu Tung Anthony, Lam, Cheung Chi Simon, Yin, Wei‐Hsian, Wei, Jeng, Lee, Yung-Tsai, Kao, Hsien-Li, Lin, Mao-Shin, Ko, Tsung-Yu, Kim, Won-Jang, Kang, Se Hun, Yun, Sung-Cheol, Ko, Euihong, Park, Hanbit, Lee, Seung-Ah, Kim, Dae-Hee, Park, Seung-Jung, and Park, Duk-Woo

Published
2023
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13. Edoxaban Versus Dual Antiplatelet Therapy for Leaflet Thrombosis and Cerebral Thromboembolism After TAVR: The ADAPT-TAVR Randomized Clinical Trial

Author

Park, Duk-Woo, Ahn, Jung-Min, Kang, Do-Yoon, Kim, Kyung Won, Koo, Hyun Jung, Yang, Dong Hyun, Jung, Seung Chai, Kim, Byungjun, Wong, Yiu Tung Anthony, Lam, Cheung Chi Simon, Yin, Wei-Hsian, Wei, Jeng, Lee, Yung-Tsai, Kao, Hsien-Li, Lin, Mao-Shin, Ko, Tsung-Yu, Kim, Won-Jang, Kang, Se Hun, Yun, Sung-Cheol, Lee, Seung-Ah, Ko, Euihong, Park, Hanbit, Kim, Dae-Hee, Kang, Joon-Won, Lee, Jae-Hong, and Park, Seung-Jung

Published
2022
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21. Sequence-Type Classification of Brain MRI for Acute Stroke Using a Self-Supervised Machine Learning Algorithm.

Author

Na, Seongwon, Ko, Yousun, Ham, Su Jung, Sung, Yu Sub, Kim, Mi-Hyun, Shin, Youngbin, Jung, Seung Chai, Ju, Chung, Kim, Byung Su, Yoon, Kyoungro, and Kim, Kyung Won

Subjects
MACHINE learning, SUPERVISED learning, MAGNETIC resonance imaging, AUTODIDACTICISM
Abstract

We propose a self-supervised machine learning (ML) algorithm for sequence-type classification of brain MRI using a supervisory signal from DICOM metadata (i.e., a rule-based virtual label). A total of 1787 brain MRI datasets were constructed, including 1531 from hospitals and 256 from multi-center trial datasets. The ground truth (GT) was generated by two experienced image analysts and checked by a radiologist. An ML framework called ImageSort-net was developed using various features related to MRI acquisition parameters and used for training virtual labels and ML algorithms derived from rule-based labeling systems that act as labels for supervised learning. For the performance evaluation of ImageSort-net (MLvirtual), we compare and analyze the performances of models trained with human expert labels (MLhumans), using as a test set blank data that the rule-based labeling system failed to infer from each dataset. The performance of ImageSort-net (MLvirtual) was comparable to that of MLhuman (98.5% and 99%, respectively) in terms of overall accuracy when trained with hospital datasets. When trained with a relatively small multi-center trial dataset, the overall accuracy was relatively lower than that of MLhuman (95.6% and 99.4%, respectively). After integrating the two datasets and re-training them, MLvirtual showed higher accuracy than MLvirtual trained only on multi-center datasets (95.6% and 99.7%, respectively). Additionally, the multi-center dataset inference performances after the re-training of MLvirtual and MLhumans were identical (99.7%). Training of ML algorithms based on rule-based virtual labels achieved high accuracy for sequence-type classification of brain MRI and enabled us to build a sustainable self-learning system. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Impact of leaflet thrombosis on valve haemodynamic status after transcatheter aortic valve replacement

Author

Jang, Mi Hee, primary, Ahn, Jung-Min, additional, Kang, Do-Yoon, additional, Kim, Kyung Won, additional, Koo, Hyun Jung, additional, Yang, Dong Hyun, additional, Jung, Seung Chai, additional, Kim, Byungjun, additional, Wong, Yiu Tung Anthony, additional, Lam, Cheung Chi Simon, additional, Yin, Wei-Hsian, additional, Wei, Jeng, additional, Lee, Yung-Tsai, additional, Kao, Hsien-Li, additional, Lin, Mao-Shin, additional, Ko, Tsung-Yu, additional, Kim, Won-Jang, additional, Kang, Se Hun, additional, Ko, Euihong, additional, Lee, Seung-Ah, additional, Kim, Dae-Hee, additional, Kim, Hoyun, additional, Choi, Yeonwoo, additional, Lee, Jinho, additional, Park, Seung-Jung, additional, and Park, Duk-Woo, additional

Published
2023
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31. Impact of leaflet thrombosis on valve haemodynamic status after transcatheter aortic valve replacement

Author

Jang, Mi Hee, Ahn, Jung-Min, Kang, Do-Yoon, Kim, Kyung Won, Koo, Hyun Jung, Yang, Dong Hyun, Jung, Seung Chai, Kim, Byungjun, Wong, Yiu Tung Anthony, Lam, Cheung Chi Simon, Yin, Wei-Hsian, Wei, Jeng, Lee, Yung-Tsai, Kao, Hsien-Li, Lin, Mao-Shin, Ko, Tsung-Yu, Kim, Won-Jang, Kang, Se Hun, Ko, Euihong, Lee, Seung-Ah, Kim, Dae-Hee, Kim, Hoyun, Choi, Yeonwoo, Lee, Jinho, Park, Seung-Jung, and Park, Duk-Woo

Abstract

ObjectivesThe effect of subclinical leaflet thrombosis, characterised by hypoattenuated leaflet thickening (HALT), on the valve haemodynamic function and durability of the bioprosthetic valve, is not yet determined. We determined the impact of HALT on valve haemodynamics after transcatheter aortic valve replacement (TAVR) and the predictors of haemodynamic structural valve deterioration (SVD).MethodsThe Anticoagulation vs Dual Antiplatelet Therapy for Prevention of Leaflet Thrombosis and Cerebral Embolization after Transcatheter Aortic Valve Replacement(ADAPT-TAVR) trial is a multicenter, randomised trial that compared edoxaban and dual antiplatelet therapy in patients who had undergone successful TAVR. The presence of HALT was evaluated by four-dimensional CT at 6 months and serial echocardiography performed at baseline, immediately post-TAVR and after 6 months. SVD was defined as at least one of the following: (1) mean transprosthetic gradient ≥20 mm Hg, (2) change in the mean gradient ≥10 mm Hg from baseline, or (3) new or increase in intraprosthetic aortic regurgitation of at least ≥1 grade, resulting in moderate or greater regurgitation.ResultsAt 6 months, HALT was found in 30 of 211 (14.2%) patients. The presence of HALT did not significantly affect aortic valve mean gradients (with vs without HALT; 14.0±4.8 mm Hg vs 13.7±5.5 mm Hg; p=0.74) at 6 months. SVD was reported in 30 of 206 patients (14.6%) at 6-month follow-up echocardiography. Older age (OR: 1.138; 95% CI: 1.019 to 1.293; p=0.033), use of aortic valve size ≤23 mm (OR: 6.254; 95% CI: 2.230 to 20.569; p=0.001) and mean post-TAVR pressure gradient (OR: 1.233; 95% CI: 1.123 to 1.371; p<0.001) were independent predictors of haemodynamic SVD; however, the presence of HALT was not identified as a predictor of SVD.ConclusionsIn patients who had undergone successful TAVR, aortic valve haemodynamic status was not influenced by the presence of HALT. Although HALT was not a predictor of haemodynamic SVD at 6 months, it warrants further longer-term follow-up to evaluate the effect on long-term valve durability.Trial registration numberNCT03284827(https://www.clinicaltrials.gov).

Published
2024
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44. A Multicenter Survey of Acute Stroke Imaging Protocols for Endovascular Thrombectomy

Author

Kim, Byungjun, You, Sung-Hye, and Jung, Seung Chai

Subjects
medicine.medical_specialty, acute stroke, Perfusion scanning, 030218 nuclear medicine & medical imaging, lcsh:RC321-571, 03 medical and health sciences, 0302 clinical medicine, medicine, In patient, cardiovascular diseases, Stroke, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, Acute stroke, Original Paper, lcsh:R5-920, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Imaging study, medicine.disease, cerebrovascular stroke, thrombectomy, Angiography, Multicenter survey, Radiology, business, lcsh:Medicine (General), 030217 neurology & neurosurgery
Abstract

Purpose: Identifying current practices in acute stroke imaging is essential for establishing optimal imaging protocols. We surveyed and assessed the current status of acute stroke imaging for endovascular thrombectomy (EVT) at tertiary hospitals throughout South Korea.Materials and Methods: An electronic questionnaire on imaging protocols for EVT in patients with acute ischemic stroke was e-mailed to physicians at 42 registered tertiary hospitals, and their responses were collected between February and March 2020.Results: Of the 36 hospitals participating in the survey, 69% (25/36) adopted computed tomography (CT)-based protocols, whereas 31% (11/36) adopted magnetic resonance (MR)-based protocols. Non-enhanced CT (NECT) was the initial imaging study at 28%, NECT with CT angiography (CTA) at 36%, and NECT with CTA and CT perfusion (CTP) at 33% of hospitals. Perfusion imaging was performed at 61% (22/36), CTP at 44% (16/36), and MR perfusion at 17% (6/36) of hospitals. Multiphase CTA was performed at 67%, single-phase CTA at 11%, time-of-flight MR angiography (MRA) at 8%, contrast-enhanced MRA at 8%, and both at 6% of hospitals. For late time window stroke, 50% of hospitals used identical imaging protocols to those for early time window stroke, 39% used additional MR imaging (MRI), and 6% converted the imaging strategy from CT to MRI. Post-processing programs were used at 28% (10/36), and RAPID software at 14% (5/36) of hospitals, respectively. Most hospitals (92%) used the same imaging protocols for posterior and anterior circulation strokes.Conclusion: Our multicenter survey demonstrated considerable heterogeneity in acute stroke imaging protocols across South Korean tertiary hospitals, suggesting that hospitals refine their imaging protocols according to hospital-specific conditions.

Published
2021

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