Technology and artificial intelligence

Risposta: Artificial intelligence (AI) is gradually being integrated into cardiological practice with the aim of facilitating early diagnosis, improving the interpretation of tests and optimising patient monitoring over time. It is not intended to replace the doctor, but rather to provide analytical support capable of rapidly processing large volumes of data and identifying clinical aspects that would otherwise not be immediately apparent.

One of the primary areas of application for AI is diagnosis in the field of cardiovascular medicine. The analysis of an electrocardiogram – a simple and widely available test – with the aid of AI allows us to extract far more information than can be immediately detected by the human eye. AI systems can, in fact, detect subtle changes in the electrocardiogram associated with cardiac arrhythmias, reduced heart function or insufficient blood flow to the heart muscle. In people arriving at A&E with chest pain of uncertain origin, the integration of AI with other laboratory parameters and clinical data can, for example, help the doctor to assess the likelihood of an ongoing heart attack more quickly and in a personalised manner.

Another important area of application for AI is diagnostic imaging. In echocardiography, AI can automate certain measurements, making them faster and more reproducible, and assisting the cardiologist in diagnosing heart muscle disorders and assessing cardiac function. In computed tomography (CT) scans of the coronary arteries – that is, the arteries that supply blood to the heart muscle – the use of AI contributes to a more accurate quantitative assessment of any ‘atherosclerotic blockages’ that restrict blood flow, but also helps to better characterise these ‘blockages’ from a qualitative perspective, for example by detecting their degree of inflammation. The risk of a heart attack, in fact, does not depend solely on the severity of the ‘atherosclerotic blockage’, but also on a multi-parameter assessment that accurately identifies the most vulnerable patients.

New technologies can also assist in the long-term monitoring of patients with cardiovascular conditions or at risk of cardiovascular disease. Smartwatches and other wearable devices – and, even more accurately, implantable cardiac devices – continuously collect information on heart rate during everyday life. This makes it possible to diagnose even asymptomatic cardiac arrhythmias, such as atrial fibrillation, and to intervene early with life-saving treatments (such as anticoagulant therapy, which reduces the risk of stroke associated with atrial fibrillation). Finally, new technologies applied to digital systems – including remote monitoring – make it possible to monitor patients with heart failure ‘remotely’, with the aim of identifying and treating clinical deterioration at an early stage, reducing the need for in-person hospital assessments and admissions, and making the system more efficient from a healthcare economics perspective as well.

However, technologically innovative systems in the healthcare sector, particularly those involving the use of AI, must nevertheless be validated on large populations in the near future, and must be able to guarantee data quality and confidentiality, whilst minimising the risk of inappropriate diagnostic and/or therapeutic recommendations. Information generated by AI always requires verification and integration with the patient’s medical history and other diagnostic tests, but above all with the cardiologist’s professional judgement.

In conclusion, AI represents a new resource for cardiology: it does not replace the cardiologist, but enhances their diagnostic and decision-making capabilities, enabling increasingly precise, timely and personalised cardiovascular care. If integrated into the decision-making process, AI could soon bring about a paradigm shift in the management of cardiovascular diseases, improving clinical outcomes and the efficiency of care pathways.