2016 Sentara Heart Annual Report

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Non Invasive Cardiology

Advanced Cardiovascular Imaging

Heart diagnosis has traditionally required catheterization, a procedure that increases both cost and patient risk. Over the last decade, pressure has mounted for faster and cheaper diagnoses, with less aggravation to patients.The healthcare community responded with dramatic improvements. Most notable is advanced coronary computed tomography (CT) scanning, an innovative tool doctors now use to non- invasively detect or rule out heart problems in patients.

Advanced cardiovascular imaging at Sentara Heart Hospital, Sentara Virginia Beach General Hospital and Sentara Williamsburg Regional Medical Center perform the most complex cardiovascular imaging within 150 miles. Our highly skilled, subspecialized doctors are using world-class technology to usher in a new era in imaging characterized by incredibly fast and accurate diagnosis of cardiovascular disease, chest pain, stroke, and other life-threatening illnesses.

As enthusiastic supporters of a wide array of cardiac clinical research studies, our echo team is perennially at the technological forefront of cardiac imaging. Throughout the Sentara Heart Network, all echo labs are fully accredited by ICAEL. Our accomplishments in echocardiography—together with rapidly growing areas such as percutaneous transcatheter aortic valve replacement and atrial fibrillation ablation—are essential to the Sentara mission of improving health every day.

  • One of the fastest and most accurate cardiac CT scanners in the region. It takes only five seconds— or five heartbeats—for this 256-slice cardiac CT scanner to create complete images of the heart and surrounding arteries.
  • An accredited Echo Lab that performs more than 1,000 echo studies every month. Extensively trained registered sonographers perform echocardiograms, which are then read the same day by a cardiologist. The availability of 3D echocardiography aids surgical decision making by enabling doctors to crop images and providing more detailed views of structures.The lab also performs 2D stress echocardiography and transesophageal echocardiography.
  • A comprehensive oncology clinic with the latest technology for echocardiographic strain, a test of myocardial function in patients undergoing chemotherapy.This procedure, which is necessary for early detection and quantification of myocardial dysfunction, can help inform therapeutic decision making. It is also useful for follow-up evaluations of therapeutic results.

IBM Watson Health

Sentara Heart continues to be a forerunner in the use of innovative technologies to improve the health of cardiovascular patients. In 2016, our non-invasive cardiology program contributed data from more than 3,000 heart echocardiograms to IBM Watson Imaging Clinical Review, a $4 billion health technology initiative spearheaded by IBM Health.

IBM Watson made a splash in 2011 when the computing system bested some well-known Jeopardy champions on television, taking home the $1 million first-place prize.The system understands natural language and reasoning and is able to learn over time.

Sentara Heart is a founding member and lead contributor to a worldwide group of 24 health institutions collaborating with IBM Health on this project. For our first endeavor, IBM Health used the information we provided to teach a computing system, known as IBM Watson Health, how to read echocardiograms and identify signs of a common heart condition called aortic stenosis.

Up to 1.5 million Americans have aortic stenosis, a condition that occurs when calcium deposits build up on the heart’s aortic valve.The valve becomes stiff and doesn’t open properly, restricting blood flow to the body and causing fatigue, shortness of breath, chest pain, dizziness or fainting.The number of people with aortic stenosis continues to rise as people live longer.

Currently, one of IBM Watson Health’s main contributions is ensuring that diagnostic test information makes its way into a patient’s medical records. IBM Watson Health minimizes the risk of this oversight by reading every single file in a heart patient’s medical record to identify new information that represents a change between a cardiologist’s report and data that should carry through to other records, such as electronic medical records, billing and insurance reports.

At present, IBM Watson Health allows for retrospective analysis only, confirming and recording cases of aortic stenosis already diagnosed by a cardiologist and ensuring the diagnosis is captured in appropriate records. In the future, the goal is to improve the accuracy of heart disease diagnosis by using artificial intelligence as a first set of eyes on diagnostic imaging tests to identify what is normal and what is not.

For instance, IBM Watson Health will read an echocardiogram and document any signs of aortic stenosis. A technician reviews the echocardiogram and the computer system’s findings, noting any additional problems. A cardiologist now has twice as much diagnostic information to work with before making a diagnosis.The addition of IBM Watson Health as a first step in imaging reading should improve accuracies and efficiencies while allowing doctors to spend less time on clerical paperwork and more time treating patients.

As IBM Watson Health learns how to read echocardiograms with more precision, it could be used to identify patients in the early stages of aortic stenosis who might benefit from early monitoring
or intervention.The system will be able to pull from a vast array of data, including medical imaging, electronic medical records, radiology and pathology reports, lab results, medical journals, research
studies and clinical care guidelines to identify potential problems and predict outcomes.

Sentara Heart will continue to collaborate with IBM Watson Health to provide data that can teach the system how to identify signs of other cardiovascular conditions, such as heart attacks, valve disorders, cardiomyopathy (disease of the heart muscle) and deep vein thrombosis. IBM Health also has plans to teach the system to read breast and lung imaging for cancer detection.