AbstractThis narrative review aims to equip clinicians with an understanding of how digital health innovations and artificial intelligence can be applied to clinical care pathways for cardiovascular prevention. We describe a case that highlights augmentative AI for the incidental detection of coronary artery calcium, a mobile application to improve patient adherence/engagement, large language models to enhance longitudinal patient communication and care, and limitations and strategies for the successful adoption of these technologies..

摘要本叙述性综述旨在使临床医生了解数字健康创新和人工智能如何应用于心血管预防的临床护理途径。我们描述了一个案例，该案例强调了用于偶然检测冠状动脉钙的增强AI，一个用于改善患者依从性/参与度的移动应用程序，用于增强纵向患者沟通和护理的大型语言模型，以及成功采用这些技术的局限性和策略。。

IntroductionThe World Health Organization (WHO) has encouraged healthcare systems to prioritize the development, evaluation, implementation, and expansion of digital health innovations (DHI) and to integrate these new technologies into existing health system infrastructures1. Similarly, in 2022, the Food and Drug Administration (FDA) commissioned a document focused on advancing the digital health landscape and highlighted the potential of DHI to improve access to care in underserved populations2.

引言世界卫生组织（WHO）鼓励医疗保健系统优先开发，评估，实施和扩展数字健康创新（DHI），并将这些新技术整合到现有的医疗保健系统基础设施中1。同样，在2022年，美国食品和药物管理局（FDA）委托编写了一份文件，重点是推进数字健康领域，并强调了DHI在改善服务不足人群获得护理方面的潜力2。

This has particular relevance for cardiovascular disease (CVD), which remains the leading cause of death worldwide3. A focus on lifestyle modification and adherence to effective preventive therapies is the cornerstone of CVD prevention and management, which can be augmented with advancing technology3.

这与心血管疾病（CVD）特别相关，心血管疾病仍然是全球死亡的主要原因3。关注生活方式的改变和坚持有效的预防性治疗是心血管疾病预防和管理的基石，这可以通过先进的技术来增强3。

DHI refers to healthcare delivered via the internet, wearable devices, mobile applications and emerging computational methods leveraging big data and artificial intelligence. Artificial intelligence (AI) is defined as the capability of a machine to imitate intelligent human behavior or perform tasks that normally require human intelligence (Fig.

DHI是指通过互联网、可穿戴设备、移动应用程序和利用大数据和人工智能的新兴计算方法提供的医疗保健。人工智能（AI）被定义为机器模仿智能人类行为或执行通常需要人类智能的任务的能力（图）。

1). A continuum of AI exists that ranges from situations where machines repeat many human tasks (assisted), enable humans to do more than they are capable of doing (augmented) and fully accomplish tasks on their own without human intervention (autonomous)1. The use of AI to improve medical diagnosis and risk assessment has increased dramatically over the past decade4,5.

1） 。人工智能的连续体存在，范围从机器重复许多人工任务（辅助）的情况，使人类能够做比他们能够做的更多（增强），并且在没有人工干预（自主）的情况下完全独立完成任务1。在过去的十年中，人工智能用于改善医学诊断和风险评估的情况急剧增加4,5。

Since the FDA first began reviewing AI-enabled devices in 1995, over 800 clinical AI-assisted algorithms have been approved, with cardiovascular disease among the top specialities for FDA-approved AI algorithms6.Fig. 1: Artificial intelligence overview.A Deep learning is a .

自1995年FDA首次开始审查人工智能设备以来，已经批准了800多种临床人工智能辅助算法，心血管疾病是FDA批准的人工智能算法的顶级专业6。图1：人工智能概述。深入学习是一种。

Data availability

数据可用性

No datasets were generated or analysed during the current study.

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Download referencesAcknowledgementsNo funding was provided for data collection, data analysis, manuscript review, writing, preparation, or the decision to submit this manuscript for publication.Author informationAuthor notesThese authors contributed equally: Jelani K. Grant, Aamir Javaid.Authors and AffiliationsJohns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USAJelani K.

下载参考文献致谢没有为数据收集，数据分析，稿件审查，写作，准备或决定提交这份稿件发表提供资金。作者信息作者注意到这些作者做出了同样的贡献：Jelani K.Grant，Aamir Javaid。作者和附属机构约翰·霍普金斯·西卡龙心血管疾病预防中心，马里兰州巴尔的摩，USAJelani K。

Grant, Aamir Javaid, Ali Asghar Kassamali, Chang H. Kim, Nino Isakadze, Michael J. Blaha, Seamus P. Whelton, Roger S. Blumenthal, Seth S. Martin & Francoise A. MarvelDepartment of Medicine, Division of Cardiology, Johns Hopkins Hospital, Baltimore, MD, USAJelani K. Grant, Aamir Javaid, Richard T. Carrick, Chang H.

格兰特（Grant），艾米尔·贾维德（Aamir Javaid），阿里·阿斯加尔·卡萨马利（Ali Asghar Kassamali），常H.金（Chang H.Kim），尼诺·伊萨卡泽（Nino Isakadze），迈克尔·J·布拉哈（Michael J.Blaha），西莫斯·P·惠尔顿（Seamus P.Whelton），罗杰·S·布卢门塔尔（Roger S.Blumenthal），塞思·S·马丁（Seth S.Martin）和弗朗索瓦·马维尔（Francoise A.Marvel）马里兰州巴尔的摩。

Kim, Nino Isakadze, Katherine C. Wu, Michael J. Blaha, Seamus P. Whelton, Armin Arbab-Zadeh, Roger S. Blumenthal, Seth S. Martin & Francoise A. MarvelDepartment of Internal Medicine, Massachusetts General Hospital, Boston, MA, USAMargaret KoesterNaples Comprehensive Health System Rooney Heart Institute, Naples, FL, USACarl OrringerWelch Center for Prevention, Epidemiology & Clinical Research, Johns Hopkins University, Baltimore, MD, USASeth S.

Kim，Nino Isakadze，Katherine C.Wu，Michael J.Blaha，Seamus P.Whelton，Armin Arbab Zadeh，Roger S.Blumenthal，Seth S.Martin＆Francoise A.Marvel马萨诸塞州总医院内科，马萨诸塞州波士顿，美国马萨诸塞州马格丽特·科斯特·那不勒斯综合卫生系统鲁尼心脏研究所，佛罗里达州那不勒斯，美国卡尔·奥林格·韦尔奇预防，流行病学和临床研究中心，约翰·霍普金斯大学，巴尔的摩，马里兰州，美国塞思·S。

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PubMed Google ScholarContributionsJ.K.G., A.J., and R.T.C. wrote the main manuscript. J.K.G. and A.J. contributed equally as co-first authors. M.K. prepared Figs. 2 and 5. A.K. prepared Figs. 3 and 4. C.H.K., N.I., K.C.W., M.J.B., S.P.W., A.A.-Z., C.O., R.S.B., S.S.M., and F.A.M.

PubMed谷歌学术贡献。K、 G.，A.J。和R.T.C.撰写了主要手稿。J、 K.G.和A.J.作为共同第一作者做出了同样的贡献。M、 K.准备图2和图5。A、 K.准备图3和图4。C、 H.K.，N.I.，K.C.W.，M.J.B.，S.P.W.，A.A.-Z.，C.O.，R.S.B.，S.S.M。和F.A.M。

reviewed the manuscript and provided feedback and suggestions. F.A.M. supervised the manuscript and was the senior author.Corresponding authorCorrespondence to.

审阅了稿件并提供了反馈和建议。F、 上午监督了手稿，是资深作者。对应作者对应。

Francoise A. Marvel.Ethics declarations

弗朗索瓦·马维尔。道德宣言

Competing interests

相互竞争的利益

Under a license agreement between Corrie Health and the Johns Hopkins University, the university owns equity in Corrie Health. F.A.M. and S.S.M. are entitled to royalty distributions related to the technology. Additionally, S.S.M. and F.A.M. are cofounders of and hold equity in Corrie Health. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.

根据科里健康和约翰·霍普金斯大学之间的许可协议，该大学拥有科里健康的股权。F、 A.M.和S.S.M.有权获得与技术相关的版税分配。此外，S.S.M.和F.A.M.是Corrie Health的共同创始人并持有其股权。约翰·霍普金斯大学已根据其利益冲突政策审查并批准了这一安排。

In addition, F.A.M. and S.S.M. have received material support for research from Apple and iHealth. S.S.M. is on the Advisory Board for Care Access and reports personal consulting fees from Amgen, Arrowhead, AstraZeneca, BMS, Chroma, HeartFlow, Kaneka, New Amsterdam, Novartis, Novo Nordisk, Pfizer, Premier, Sanofi, 89bio, and Verve Therapeutics.

此外，F.A.M.和S.S.M.还获得了苹果和iHealth的物质支持。S、 S.M.是护理访问咨询委员会的成员，并报告了安进（Amgen）、箭头（Arrowhead）、阿斯利康（AstraZeneca）、BMS、Chroma、HeartFlow、卡内卡（Kaneka）、新阿姆斯特丹（New Amsterdam）、诺华（Novartis）、诺和诺德（Novo Nordisk）、辉瑞（Pfizer）、Premier、赛诺菲（Sanofi）、89bio和Verve Therapeutics）的。

S.S.M. reports research support from the American Heart Association Health Technologies and Innovation Strategically Focused Research Network (20SFRN35380046, 20SFRN35490003), a collaborative project of this network (#878924), and additional American Heart Association support (#882415, #946222). He also reports support from the Patient-Centered Outcomes Research Institute (ME-2019C1-15 328, IHS-2021C3-24147), the National Institutes of Health (NIH) (P01 HL108800 and R01AG071032), the David and June Trone Family Foundation, the Pollin Digital Innovation Fund, Sandra and Larry Small, Google, and Merck.

S、 S.M.报告了美国心脏协会健康技术与创新战略重点研究网络（20SFRN3538004620SFRN35490003）的研究支持，该网络是该网络的一个合作项目（#878924），以及美国心脏协会的额外支持（#882415，#946222）。他还报告了以患者为中心的成果研究所（ME-2019C1-15 328，IHS-2021C3-24147），美国国立卫生研究院（NIH）（P01 HL108800和R01AG071032），David和June Trone家庭基金会，Pollin数字创新基金，Sandra和Larry Small，谷歌和默克的支持。

F.A.M. reports personal consulting fees from Apple, Amgen, and Kaneka. The other authors declare no competing interests..

F、 A.M.报告了苹果、安进和卡内卡的个人咨询费。其他作者声明没有利益冲突。。

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Reprints and permissionsAbout this articleCite this articleGrant, J.K., Javaid, A., Carrick, R.T. et al. Digital health innovation and artificial intelligence in cardiovascular care: a case-based review.

转载和许可本文引用本文Grant，J.K.，Javaid，A.，Carrick，R.T。等人。心血管护理中的数字健康创新和人工智能：基于案例的评论。

npj Cardiovasc Health 1, 26 (2024). https://doi.org/10.1038/s44325-024-00020-yDownload citationReceived: 09 July 2024Accepted: 22 August 2024Published: 17 October 2024DOI: https://doi.org/10.1038/s44325-024-00020-yShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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