ABSTRACT
Heart failure imposes a tremendous burden of morbidity and mortality, costing the United States in excess of
$31 billion annually. An increasingly recognized major determinant of outcomes in heart failure is right ventricular
(RV) dysfunction. However, the nature and character of RV contribution to cardiovascular outcomes remains
poorly understood, largely due to the imprecision of imaging and interpretation of RV morphology and function.
Echocardiography, with its high temporal resolution and low cost of acquisition, serves as frontline cardiovascular
imaging and a mainstay in approaches to assessing RV morphology and function. However, echocardiographic
imaging of the RV is limited by factors that include technical variation in image acquisition and heterogeneity in
image assessment as well as overall interpretation. We postulate that deep learning based phenotyping can
offer the ability to not only more precisely characterize RV function but also classify RV imaging phenotypes
according to etiologic disease states and, even further, refine prognostic evaluations of future cardiovascular
risk. Therefore, in Aim 1, we will use video-based deep learning segmentation models to assess RV function,
evaluate its cross-sectional relation with a range of expert-measured parameters, and examine its variation in
the context of patient characteristics derived from large hospital-based cohorts. In Aim 2, we will use video-based
deep learning models to produce imaging-based classification of RV disease and assess the ability of
unsupervised approaches to classify RV dysfunction into various categories of disease etiology. In Aim 3, we
will use models developed in part from training in Aims 1 and 2 to predict major cardiovascular outcomes
including heart failure in addition to coronary artery disease, stroke, and cardiovascular death in both hospital-
based and community-based cohorts. The overarching goal of this proposal is to improve the precision and
standardization of RV phenotyping and determine the extent to which deep learning models can augment human
assessment of the RV. This research will be accomplished in the setting of a comprehensive career development
program designed to provide the candidate with the skills needed to become an independent physician-scientist
in cardiovascular medicine and translational imaging science. An advisory committee of established
scientists/mentors in the fields of cardiac imaging, deep learning, data science, and translational science will
guide the candidate in his transition to scientific independence over the course of the award period.