About the App
This application is designed to predict MACE-free-survival in patients with severe aortic stenosis scheduled for aortic valve replacement.
Using a machine learning model, the app provides estimates of MACE-free-survival probability at 1, 2, and 3 years based on patient-specific cardiac and aortic calcifications.
How to Use the App:
- Navigate to the 'Prediction' tab.
- Input patient-specific data in the provided fields.
- Click the button below to view the results.
- Using the TTA tab you get the TTA score, while using the TC tab you get the MACE-free-survival probabilities with 95% confidence intervals, along with a comparison of the new patient to the distribution of the training data. The application provides placement of new patients in the first (worst survival), second, third, or fourth quartile (best survival).
Key Features
The following scores are used in this application to calculate survival predictions based on patient-specific cardiac and aortic calcifications:
-
CAC (Coronary Artery Calcification):
Classified following the visual assessment system proposed in 2022. DOI: 10.1016/j.jcct.2022.07.002;
-
MAC (Mitral Annular Calcification):
Defined according to the study by Guerrero et al. DOI: 10.1016/j.jcmg.2020.03.013;
-
AVC (Aortic Valve Calcification):
Defined based on the Win Registry guidelines. DOI: 10.1016/j.jcct.2018.04.007;
-
TAC (Thoracic Aorta Calcufication):
Assessed using the Vos classification system for the ascending aorta, aortic arch, and descending aorta. DOI: 10.1016/j.ejrad.2023.110687.
The classes assigned to ascending, descending and arch Thoracic Aorta are then combined to a Total Thoracic Aorta (TTA) Score, as the sum of 3 items, as follows (see the Figure below):
-
Item 1. Total Number of Aortic Sites with calcification:
Scores from 0 to 3 based on how many segments of the aorta (none, ascending, descending, arch) are affected.
-
Item 2. Number of Sites with Calcification Thickness > 1.5 mm:
Scores from 0 to 3 depending on how many segments (none, ascending, descending, arch) have significant calcification.
-
Item 3. Extent of Calcifications in Terms of Annularity:
Scores from 0 to 9 depending on the degree of circumferential involvement. Specifically, the item counts how many calcifications with annularity < 90°, between 90° and 270° and > 270° are present in the various sections of the aorta, assigning a weight of 1, 2 and 3, respectively. In the worst case, the presence of an angle > 270° at each site of the aorta leads the third item to have the maximum value of 9.
Ready to begin?
Head over to the 'Prediction' tab to input patient data and get started!