Right heart dysfunction identification, right heart hemodynamic identification and auxiliary decision-making system

Abstract

The invention relates to the technical field of medical information collection, in particular to a right heart dysfunction recognition, right heart hemodynamic recognition and auxiliary decision making system. The right heart dysfunction recognition system comprises a first image acquisition module, a first image processing and recognition module, a first index calculation module or / and sign recognition module and a right heart dysfunction recognition and classification module. The right heart hemodynamic identification system comprises a right heart-to-left heart influence degree grading module, a right heart dysfunction potential reason classification module, a hemodynamic consequence analysis module, a pulmonary arterial hypertension identification module, a right heart hemodynamic classification module and the right heart dysfunction identification system. By means of the system, right heart dysfunction recognition can be completed by conducting structured arrangement on right heart information, hemodynamic phenotypes of right ventricle protection can be recognized, and then relevant diagnosis and treatment decision suggestions can be given in an auxiliary mode.

Description

Technical Field

[0001] The present invention relates to the technical field of medical information collection, and more specifically to right heart dysfunction identification, right heart hemodynamics identification and auxiliary decision-making systems. Background Art

[0002] In the past, it was generally believed that the left heart was the key to determining cardiac output, arterial blood pressure, tissue perfusion and maintaining effective circulation. However, the development of bedside hemodynamic monitoring methods and advanced visualization technology has confirmed that the right heart is as important as the left heart in cardiovascular homeostasis. Especially for critically ill patients, a variety of factors can cause acute right heart dysfunction, mainly due to increased afterload. Among patients with acute respiratory distress syndrome (ARDS) who are mechanically ventilated, 14%-50% develop acute cor pulmonale (ACP), most of which are around 25%, and acute right heart dysfunction is closely related to the poor prognosis of ICU patients. Due to its unique myocardial structure and configuration, its position in the circulation, and some particularities for critically ill patients, the right heart has more special needs, unique characteristics, and evaluation difficulties in the ICU than the left heart. For example, the structure of the two layers of oblique muscles in the right heart leads to good capacity tolerance and poor pressure tolerance. When there is a problem with the pulmonary circulation, it is very easy to cause acute progressive right heart failure; ICU patients are very prone to respiratory dysfunction, which leads to spasm, contraction, and tortuosity of the pulmonary circulation, which leads to increased right heart afterload and a high incidence of acute right heart dysfunction. Since the right heart is at the end of the systemic circulation venous return and the source of left heart capacity, once right heart dysfunction occurs, on the one hand, it will lead to insufficient left heart capacity, and once the left heart contraction is affected through the ventricular septum, it will further reduce the left heart output. On the other hand, venous return obstruction, organ congestion, and abnormal organ perfusion will lead to organ dysfunction, which is an important link in the aggravation of the condition of ICU patients. Therefore, inexperienced doctors can easily miss right heart-related information and be disturbed by other clinical information when executing shock diagnosis and treatment plans, affecting the timeliness and standardization of diagnosis and treatment.

[0003] The emergence of critical ultrasound has made the assessment of right ventricular function more convenient, real-time, non-invasive and accurate. The measurement indicators of right ventricular systolic function mainly include right ventricular ejection fraction RVEF, area change rate FAC, tricuspid valve annulus root displacement TAPSE, stroke volume SV and tricuspid valve regurgitation pressure difference (which can indirectly reflect pulmonary artery pressure). Right ventricular contraction mainly shortens longitudinally in a peristaltic manner, so it is considered reliable to represent the contraction of the right ventricle by the longitudinal displacement of the tricuspid valve annulus root. And based on the results of critical ultrasound assessment, it can not only monitor and warn in real time, classify the right heart hemodynamic phenotype and even guide clinical diagnosis and treatment, improve prognosis, and can be used in many scenarios such as shock diagnosis and treatment, mechanical ventilation parameter adjustment, and high-altitude pulmonary edema. However, the current assessment of critical ultrasound requires special training, and it is highly dependent on the relevant knowledge, skills, and experience of clinical physicians in critical ultrasound and critical right heart-related hemodynamics, which is easily overlooked in clinical practice. Summary of the invention

[0004] In order to overcome the defects and shortcomings existing in the above-mentioned prior art, the present invention provides a right heart dysfunction identification, right heart hemodynamic identification and auxiliary decision-making system based on right heart protection. By structuring the information of the right heart, the right heart dysfunction can be identified, and the hemodynamic phenotype of right ventricular protection can be identified, and then relevant diagnosis and treatment decision-making suggestions can be given in an auxiliary manner, filling the current gap in real-time monitoring of right heart hemodynamics.

[0005] The present invention is achieved by adopting the following technical solutions: Right heart dysfunction identification system, including A first image acquisition module, used for acquiring ultrasound images of different sections of the heart through a cardiac ultrasound probe, and transmitting the images to a first image processing and recognition module; The first image processing and recognition module is used to pre-process the received ultrasound images to obtain qualified ultrasound images of each section, and identify the left ventricular endocardium of the four-chamber heart section, the right ventricular endocardium of the four-chamber heart section, the right atrial endocardium of the four-chamber heart section, the left atrial endocardium of the four-chamber heart section, the right ventricular free wall endocardium of the four-chamber heart section, the four-chamber ventricular septum endocardium and the root of the right ventricular free wall annulus of the tricuspid valve in the qualified ultrasound images of each section; a first indicator calculation module and / or a sign recognition module, wherein the sign recognition module is used to identify each sign according to the area identified in the qualified ultrasound image of each section; the first indicator calculation module is used to calculate the first indicator corresponding to each sign according to the area identified in the qualified ultrasound image of each section; the signs include whether the right ventricular free wall is thickened, whether the right atrium is enlarged, whether the right ventricle is enlarged, and whether the right heart contraction function is decreased; The right heart dysfunction identification and classification module is used to identify each sign based on the signs identified by the sign identification module; or / and based on the first indicator calculated by the first indicator calculation module; and to identify whether there is right heart dysfunction and classify the acuteness or chronicity of the dysfunction.

[0006] The different heart sections include the transthoracic apical four-chamber heart section and / or the subcostal four-chamber heart section.

[0007] The first indicator corresponding to whether the right ventricular free wall is thickened includes the right ventricular free wall thickness; the first indicator corresponding to whether the right atrium is enlarged includes the right atrium area; the first indicator corresponding to whether the right ventricle is enlarged includes the left ventricular end-diastolic endocardial area and the right ventricular end-diastolic endocardial area.

[0008] The specific calculation methods of each first indicator include: calculating the left ventricular end-diastolic endocardial area based on the left ventricular endocardium in the four-chamber heart view, calculating the right ventricular end-diastolic endocardial area based on the right ventricular endocardium in the four-chamber heart view; calculating the right ventricular free wall thickness based on the right ventricular free wall endocardium in the four-chamber heart view; calculating the right atrial area based on the right atrial endocardium in the four-chamber heart view.

[0009] The first indicators corresponding to whether the right heart systolic function is decreased include tricuspid valve annulus root displacement TAPSE, right ventricular area change rate RV-FAC, right ventricular free wall contraction rate and right ventricular septum contraction rate.

[0010] The specific calculation method of the first indicator corresponding to whether the right heart systolic function is decreased includes: calculating the tricuspid valve annulus root displacement TAPSE based on the tricuspid valve right ventricular free wall annulus root; calculating the right ventricular area change rate RV-FAC based on the right ventricular endocardium in the four-chamber heart section; calculating the right ventricular free wall contraction rate based on the right ventricular free wall endocardium; calculating the right ventricular septum contraction rate based on the four-chamber ventricular septum endocardium.

[0011] If the tricuspid valve annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall contraction rate and the right ventricular septum contraction rate are all higher than the corresponding upper limit thresholds, it is judged that the right heart systolic function has not declined; if one or more of the tricuspid valve annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall contraction rate and the right ventricular septum contraction rate are lower than the corresponding lower limit threshold, it is judged that the right heart systolic function has declined.

[0012] It is identified whether there is right heart function disorder and the acuteness and chronicity of the disorder are classified. Specifically: if the right ventricle is not enlarged, the right atrium is not enlarged, the right ventricular free wall is not thickened, and the right heart systolic function is not decreased, then it is identified as no obvious abnormality in right heart function; if the right ventricle is enlarged, the right heart systolic function is decreased, the right ventricular free wall is not thickened, and the right atrium is not enlarged, then it is identified as acute right heart dysfunction; if the right ventricle is enlarged, the right ventricular free wall is thickened or the right atrium is enlarged, and the right heart systolic function is decreased, then it is identified as chronic right heart dysfunction or chronic right heart dysfunction + acute exacerbation.

[0013] A right heart hemodynamic identification system comprises a module for grading the degree of influence of the right heart on the left heart, a module for classifying potential causes of right heart dysfunction, a module for analyzing hemodynamic consequences, a module for identifying pulmonary hypertension, a module for classifying right heart hemodynamics and a system for identifying right heart dysfunction; the module for grading the degree of influence of the right heart on the left heart is used to obtain a grading result of the degree of influence of the right heart on the left heart; the module for classifying potential causes of right heart dysfunction is used to obtain a classification result of potential causes of right heart dysfunction; the module for analyzing hemodynamic consequences is used to judge the hemodynamic consequences; the module for identifying pulmonary hypertension is used to judge whether there is pulmonary hypertension; the module for classifying right heart hemodynamics is used to classify the right heart hemodynamic phenotype according to the grading result of the degree of influence of the right heart on the left heart, the classification result of potential causes of right heart dysfunction, the hemodynamic consequences, whether there is pulmonary hypertension, and whether there is right heart function disorder and whether the disorder is acute or chronic.

[0014] It also includes a second image acquisition module, a second image processing and recognition module and a second index calculation module; the second image acquisition module is used to acquire ultrasound images of different sections of the heart through a cardiac ultrasound probe, and transmit them to the second image processing and recognition module, and is also used to acquire Doppler blood flow spectrum diagram; the second image processing and recognition module is used to pre-process the received ultrasound images to obtain qualified ultrasound images of each section, and identify the left ventricular endocardium of the parasternal left ventricular short axis section, the ventricular septum endocardium of the parasternal left ventricular short axis section, the right ventricular endocardium of the parasternal left ventricular short axis section, the root of the apical five-chamber aortic valve, and the root of the pulmonary artery in the pulmonary artery long axis / right ventricular outflow tract section in the qualified ultrasound images of each section; the second index calculation module is used to calculate each second index according to the Doppler blood flow spectrum diagram and the areas identified in the qualified ultrasound images of each section; the second index includes the tricuspid regurgitation pressure difference TR-PG and a second index for judging the hemodynamic consequences.

[0015] Different views of the heart include the apical five-chamber view, the parasternal left ventricular short-axis view, and the pulmonary artery long-axis / right ventricular outflow tract view.

[0016] The second indexes used to judge the hemodynamic consequences include: aortic velocity integral AV-VTI, aortic valve stroke volume AV-SV, pulmonary artery velocity time integral PV-VTI and pulmonary artery stroke volume PV-SV.

[0017] The module for grading the degree of influence of the right heart on the left heart is used to obtain the grading result of the degree of influence of the right heart on the left heart, specifically referring to: grading the degree of influence of the right heart on the left heart according to the morphology and staging of the ventricular septum in the parasternal left ventricular short-axis view or / and the eccentric index calculated based on the ventricular septum endothelium in the parasternal left ventricular short-axis view.

[0018] The degree of influence of the right heart on the left heart is graded as normal, mild, moderate, and severe.

[0019] If there is no D sign in the ventricular septum in the parasternal short-axis view, the influence of the right heart on the left heart is normal; if there is jitter in the ventricular septum in the parasternal short-axis view, the influence of the right heart on the left heart is mild; if there is a diastolic D sign in the ventricular septum in the parasternal short-axis view, the influence of the right heart on the left heart is moderate; if there is a double-phase D sign in the ventricular septum in the parasternal short-axis view, the influence of the right heart on the left heart is severe.

[0020] When the diastolic D sign of the ventricular septum in the parasternal left ventricular short-axis view or the double-phase D sign of the ventricular septum in the parasternal left ventricular short-axis view appears, the eccentric index is calculated through the ventricular septum endothelium of the parasternal left ventricular short-axis view to further determine the degree of influence of the right heart on the left heart.

[0021] The right heart dysfunction potential cause classification module is used to complete the classification of potential causes of right heart dysfunction, specifically referring to: drawing a parasternal left ventricular short-axis ventricular septum motion trajectory curve based on the parasternal left ventricular short-axis section ventricular septum endothelium, or drawing a four-chamber heart right ventricular free wall and ventricular septum motion trajectory curve based on the right ventricular free wall endothelium and the four-chamber heart ventricular septum endothelium; judging whether the potential cause of right heart dysfunction is mainly right heart volume overload or right heart pressure overload through the morphology of the parasternal left ventricular short-axis ventricular septum motion trajectory curve or the four-chamber heart right ventricular free wall and ventricular septum motion trajectory curve.

[0022] The classification of right heart hemodynamic phenotypes specifically includes: acute right heart-related phenotype with a significant decrease in left ventricular output caused mainly by pulmonary hypertension, normal left heart output phenotype caused by chronic right heart dysfunction, and mild right heart enlargement caused by volume overload, resulting in a mild decrease in left heart output phenotype.

[0023] If the tricuspid regurgitation pressure gradient TR-PG is higher than the corresponding threshold or the potential cause of right heart dysfunction is mainly pressure overload, and there is acute right heart dysfunction, and the degree of right heart influence on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and aortic valve stroke volume AV-SV are both lower than the corresponding threshold, then it is an acute right heart-induced phenotype with a significant decrease in left heart output caused mainly by pulmonary hypertension; If the tricuspid regurgitation pressure gradient TR-PG is higher than the corresponding threshold or the potential cause of right heart dysfunction is mainly pressure overload, and there is chronic right heart dysfunction, and the degree of right heart influence on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and aortic valve stroke volume AV-SV are higher than the corresponding threshold, then the phenotype of chronic right heart dysfunction and normal left heart output is considered; If the potential cause of right heart dysfunction is mainly right heart volume overload, the right ventricle is enlarged, and one or both of the aortic velocity integral AV-VTI and the aortic valve stroke volume AV-SV are lower than the corresponding threshold, then it is a phenotype of mild right heart enlargement caused by volume overload and mild decrease in left heart output.

[0024] It also includes an early warning module, which issues a preliminary early warning if acute right heart dysfunction exists; if acute right heart dysfunction exists and the degree of influence of the right heart on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and the aortic valve stroke volume AV-SV are both lower than the corresponding thresholds, a high early warning is issued.

[0025] A decision-making support system performs decision-making support based on the classification results of the right heart hemodynamic phenotype by a right heart hemodynamic recognition system.

[0026] The auxiliary decision specifically refers to: if the right heart hemodynamic phenotype is an acute right heart-derived phenotype with a significant decrease in left ventricular output caused mainly by pulmonary hypertension, then the treatment is mainly to screen the causes of increased right heart afterload, evaluate the lungs and pulmonary blood vessels, and relieve obstruction; if the right heart hemodynamic phenotype is a chronic right heart dysfunction phenotype with normal left heart output, then the treatment is mainly to carefully manage fluid output, closely monitor dynamic change trends, and issue early warnings; if the right heart hemodynamic phenotype is a mild decrease in left heart output caused by mild right heart enlargement due to volume overload, then the treatment is mainly to dehydrate and diuresis.

[0027] Compared with the prior art, the beneficial effects of the present invention are as follows: 1. The present invention proposes a right heart dysfunction identification system, which can structure and organize the information of the right heart, complete the identification of right heart dysfunction and the classification of acute and chronic types, and solve the problem of difficulty in identifying right heart dysfunction due to the more special needs, unique characteristics and evaluation difficulties of the right heart compared with the left heart. Based on the right heart dysfunction identification system, when medical staff assist in diagnosis and treatment, data support can be quickly provided, which is convenient for clinical interpretation of right heart dysfunction, and is faster and does not require special training, avoiding the problem of untimely and non-standard diagnosis and treatment when medical staff diagnose and treat, for example, when executing shock diagnosis and treatment plans, and solving the problem of easy omission of right heart related information.

[0028] 2. In the present invention, when collecting data, it is only necessary to collect the transthoracic apical four-chamber heart view and / or the subcostal four-chamber heart view and the parasternal short-axis ultrasound image. The subsequent identification and parameter calculation are automatically completed, and data collection is simpler.

[0029] 3. In the present invention, the tricuspid valve annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall contraction rate and the right ventricular septum contraction rate are used to comprehensively judge whether the right heart contraction function is reduced. The judgment result is more accurate, which is convenient for improving the accuracy of identifying right heart dysfunction.

[0030] 4. In the present invention, the change of right ventricular area, the area of ​​the right atrium of the four-chamber heart, the thickness of the right ventricular wall of the subcostal four-chamber heart and the right heart contraction function are used to comprehensively judge whether there is any disorder in the right heart function, and the acuteness or chronicity of the disorder is classified, so that the identification and classification results are more accurate.

[0031] 5. In the present invention, right heart hemodynamic phenotypes are classified based on different right heart dysfunctions, the degree of right heart influence on the left heart, potential causes of right heart dysfunction, hemodynamic consequences, and whether pulmonary hypertension exists. Through the mutual cooperation of various factors, the results of right heart hemodynamic phenotype classification are more accurate, solving the problem of difficult right heart assessment, and clearly finding the main cause of hemodynamic disorder in critically ill patients, which can fill the gap in the current real-time monitoring of right heart hemodynamics.

[0032] 6. In the present invention, the degree of influence of the right heart on the left heart is further distinguished by calculating the eccentric index, and the auxiliary decision made later is more accurate. When the morphology and stage of the ventricular septum in the parasternal left ventricular short axis section cannot be determined, the degree of influence of the right heart on the left heart can also be directly graded using the eccentric index.

[0033] 7. The present invention can more intuitively observe the ventricular wall movement during the contraction and relaxation process through the parasternal left ventricular short-axis ventricular septum motion trajectory curve or the shape of the right ventricular free wall and ventricular septum motion trajectory curve of the four-chamber heart, and can better determine the potential causes of right heart dysfunction.

[0034] 8. The present invention also proposes an auxiliary decision-making system, which can provide targeted assistance and relevant diagnosis and treatment decision-making suggestions based on the classification results of the right heart hemodynamics phenotype by the right heart hemodynamics identification system, so as to guide medical staff to carry out targeted treatment. BRIEF DESCRIPTION OF THE DRAWINGS

[0035] The present invention will be further described in detail below with reference to the accompanying drawings and specific embodiments, wherein: Figure 1 It is a schematic diagram of the structure of the right heart hemodynamics identification system in the present invention. DETAILED DESCRIPTION

[0036] Example 1 As a basic embodiment of the present invention, the present invention includes a right heart dysfunction identification system, including: The first image acquisition module is used to acquire ultrasound images of different sections of the heart through a cardiac ultrasound probe and transmit them to the first image processing and recognition module.

[0037] The first image processing and recognition module is used to preprocess the received ultrasound images to obtain qualified ultrasound images of each section, and identify the left ventricular endocardium of the four-chamber heart section, the right ventricular endocardium of the four-chamber heart section, the right atrial endocardium of the four-chamber heart section, the left atrial endocardium of the four-chamber heart section, the right ventricular free wall endocardium of the four-chamber heart section, the four-chamber ventricular septum endocardium and the root of the right ventricular free wall annulus of the tricuspid valve in the qualified ultrasound images of each section.

[0038] A first indicator calculation module and / or a sign recognition module, wherein the sign recognition module is used to recognize each sign according to the area recognized in the qualified ultrasound image of each section. The first indicator calculation module is used to calculate the first indicator corresponding to each sign according to the area recognized in the qualified ultrasound image of each section. The signs include whether the right ventricular free wall is thickened, whether the right atrium is enlarged, whether the right ventricle is enlarged, and whether the right heart contraction function is decreased.

[0039] The right heart dysfunction identification and classification module is used to identify each sign based on the signs identified by the sign identification module; or / and based on the first indicator calculated by the first indicator calculation module; and to identify whether there is right heart dysfunction and classify the acuteness or chronicity of the dysfunction.

[0040] Example 2 As a preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the first image acquisition module and the first image processing and recognition module on the basis of the above-mentioned embodiment 1. In this embodiment, the cardiac ultrasound probe can be a cardiac adhesive / patch / wearable probe or a cardiac implantable probe. When the cardiac ultrasound probe is a transthoracic cardiac adhesive probe, it can be fixed on the subject by an adhesive or wearable installation method. When the cardiac ultrasound probe is a cardiac implantable probe, it can be fixed on the subject by an esophageal implantation installation method.

[0041] In this embodiment, the received ultrasound images may be preprocessed using conventional technical means in the art, for example, the ultrasound images of different sections of the heart collected may be processed frame by frame into ultrasound images, and all ultrasound images may be subjected to image noise reduction and data enhancement processing. Image noise reduction and data enhancement are also conventional technical means in the art, and will not be described in detail in this embodiment.

[0042] The processed ultrasound images are screened out according to the standard of ultrasound images of different sections of the heart using the pre-trained ultrasound qualified image classification model of each section. The ultrasound qualified image classification model of each section is obtained based on the research and training in the prior art, wherein a ultrasound qualified image classification model is trained for each section ultrasound image. The model used for training can be Unet, Inception V3, ResNet50, LeNet-5, etc. This application does not limit this.

[0043] The pre-trained ultrasound image recognition model of each section of the heart is used to perform image segmentation on the screened qualified ultrasound images, segment the regions of interest in the qualified ultrasound images of each section, and identify and label different regions of interest. The ultrasound image recognition model of each section of the heart can be a neural network model, which is not limited in this application. The training method also adopts conventional technical means in this field, which is not limited in this application.

[0044] Specifically, the first image acquisition module can obtain ultrasound images of the transthoracic apical four-chamber view and / or the subcostal four-chamber view. The first image processing and recognition module can recognize and mark the left ventricular endocardium of the four-chamber view, the right ventricular endocardium of the four-chamber view, the right atrial endocardium of the four-chamber view, the left atrial endocardium of the four-chamber view, the right ventricular free wall endocardium of the four-chamber view, the four-chamber septal endocardium, and the root of the right ventricular free wall annulus of the tricuspid valve in the transthoracic apical four-chamber view and / or the subcostal four-chamber view.

[0045] Example 3 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and explanation of the first index calculation module and the sign recognition module based on the above-mentioned embodiment 1 or embodiment 2. Among them, the right heart dysfunction recognition system can have both the first index calculation module and the sign recognition module, or only one of the two.

[0046] When the right heart dysfunction identification system only includes the first indicator calculation module, the first indicator calculation module is used to calculate the first indicator corresponding to each sign according to the area identified in the qualified ultrasound image of each section. The first indicator includes the first indicator corresponding to whether the right ventricular free wall is thickened, the first indicator corresponding to whether the right atrium is enlarged, the first indicator corresponding to whether the right ventricle is enlarged, and the first indicator corresponding to whether the right heart systolic function is decreased. Among them, the first indicator corresponding to whether the right ventricular free wall is thickened includes the right ventricular free wall thickness; the first indicator corresponding to whether the right atrium is enlarged includes the right atrium area; the first indicator corresponding to whether the right ventricle is enlarged includes the left ventricular end-diastolic endocardial area and the right ventricular end-diastolic endocardial area. The first indicator corresponding to whether the right heart systolic function is decreased includes the tricuspid valve annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall contraction rate, and the right ventricular septum contraction rate.

[0047] When the right heart dysfunction identification system only includes a sign identification module, each sign can be identified according to the area identified in the qualified ultrasound image of each section. The sign identification module may include a pre-trained classification model for each sign. The neural network model used to train the classification model for identifying each sign may be Inception V3, ResNet50, LeNet-5, etc. This application does not limit this.

[0048] When the right heart dysfunction identification system includes both the first indicator calculation module and the sign identification module, they can complement each other according to needs and convenience.

[0049] Example 4 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the first indicator calculation module based on the above-mentioned embodiment 3. This embodiment can calculate the left ventricular end-diastolic endocardial area based on the marked left ventricular endocardium of the four-chamber heart section, and calculate the right ventricular end-diastolic endocardial area based on the right ventricular endocardium of the four-chamber heart section. The right ventricular free wall thickness is calculated based on the marked right ventricular free wall endocardium of the four-chamber heart section. The right atrial area is calculated based on the marked right atrial endocardium of the four-chamber heart section. The tricuspid valve annulus root displacement TAPSE is calculated based on the marked tricuspid valve right ventricular free wall annulus root. The right ventricular area change rate RV-FAC is calculated based on the marked right ventricular endocardium of the four-chamber heart section. The right ventricular free wall contraction rate is calculated based on the marked right ventricular free wall endocardium. The right ventricular septum contraction rate is calculated based on the marked four-chamber ventricular septum endocardium.

[0050] Example 5 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the right heart dysfunction identification and classification module based on any one of the above embodiments 1 to 4. The right heart dysfunction identification and classification module identifies whether there is right heart dysfunction and classifies the acuteness and chronicity of the dysfunction, specifically: If the right ventricle is not enlarged, the right atrium is not enlarged, the right ventricular free wall is not thickened, and the right heart systolic function is not decreased, it is identified as no obvious abnormality in right heart function. If the right ventricle is enlarged, the right heart systolic function is decreased, the right ventricular free wall is not thickened, and the right atrium is not enlarged, it is identified as acute right heart dysfunction. If the right ventricle is enlarged, the right ventricular free wall is thickened or the right atrium is enlarged, and the right heart systolic function is decreased, it is identified as chronic right heart dysfunction or chronic right heart dysfunction + acute exacerbation.

[0051] Among them, whether the right ventricle is enlarged can be identified by the sign recognition module; or it can be identified by the left ventricular end-diastolic endothelial area and the right ventricular end-diastolic endothelial area calculated by the first indicator calculation module. Specifically, it can be judged whether the right ventricle is enlarged by the ratio of the left ventricular end-diastolic endothelial area to the right ventricular end-diastolic endothelial area. If the ratio is less than the threshold value A1, it is judged that the right ventricle is not enlarged. If the ratio is greater than the threshold value A2, it is judged that the right ventricle is enlarged. Among them, A1 is less than A2. In this embodiment, A1 can be 0.6 and A2 can be 1.

[0052] Whether the right atrium is enlarged can be identified by the sign recognition module; or it can be determined by the right atrium area of ​​the four-chamber heart calculated by the first indicator calculation module. If the right atrium area of ​​the four-chamber heart is less than the corresponding threshold, it means that the right atrium is not enlarged, and if the right atrium area of ​​the four-chamber heart is greater than the corresponding threshold, it means that the right atrium is enlarged.

[0053] Whether the right ventricular free wall is thickened can be identified by the sign identification module; or it can be determined by the right ventricular free wall thickness calculated by the first index calculation module. If the right ventricular free wall thickness is less than the corresponding threshold value of 0.5 cm, the right ventricular free wall is not thickened, and if the right ventricular free wall thickness is greater than the corresponding threshold value of 0.5 cm, the right ventricular free wall is thickened.

[0054] Whether the right heart systolic function is decreased can be identified by the sign recognition module; or it can be determined by the tricuspid valve ring root displacement TAPSE, right ventricular area change rate RV-FAC, right ventricular free wall contraction rate and right ventricular septum contraction rate calculated by the first index calculation module. If the tricuspid valve ring root displacement TAPSE, right ventricular area change rate RV-FAC, right ventricular free wall contraction rate and right ventricular septum contraction rate are all higher than the corresponding upper threshold value B2, it is judged that the right heart systolic function has not decreased; if one or more of the tricuspid valve ring root displacement TAPSE, right ventricular area change rate RV-FAC, right ventricular free wall contraction rate and right ventricular septum contraction rate are lower than the corresponding lower threshold value B1, it is judged that the right heart systolic function is decreased. The upper threshold value B2 and the lower threshold value B1 are set relatively, and the upper threshold value B2 is greater than the lower threshold value B1.

[0055] Example 6 As another preferred embodiment of the present invention, refer to the attached Figure 1 The present invention includes a right heart hemodynamics identification system, including a right heart influence on left heart grading module, a right heart dysfunction potential cause classification module, a hemodynamic consequence analysis module, a pulmonary hypertension identification module, a right heart hemodynamics classification module and the right heart dysfunction identification system in the above-mentioned embodiment 5.

[0056] The module for grading the degree of influence of the right heart on the left heart is used to obtain the grading result of the degree of influence of the right heart on the left heart. The module for classifying the potential causes of right heart dysfunction is used to obtain the classification result of the potential causes of right heart dysfunction. The module for analyzing the hemodynamic consequences is used to determine the hemodynamic consequences, that is, to determine the influence on the right heart output. The module for identifying pulmonary hypertension is used to determine whether pulmonary hypertension exists.

[0057] Because the right heart is difficult to evaluate, the characteristics of different right heart disorders determine the different degrees of impact on hemodynamics and different prognoses. At the same time, the characteristics of different right heart disorders indicate different causes of right heart disorders, leading to different targeted treatments. For example, the D-sign of the ventricular septum determines the degree of increase in right heart pressure and the impact of the degree of disorder on the left heart, which is the main cause of the impact on hemodynamics. The left heart output is the consequence. By distinguishing the two, the main cause of hemodynamic disorders in critically ill patients can be clearly found and targeted treatment can be performed. In the potential cause analysis, volume overload / pressure overload also clearly leads to different targeted fluid treatments or targeted evaluation and treatment of factors that increase right heart afterload pressure (lung / pulmonary circulation). The right heart contraction function assists clinicians in determining whether inotropic drugs are needed, and the right heart contraction combined with the right heart pressure state determines the management of fluids (if the right heart pressure is high, then cautious fluid therapy or even reverse fluid therapy is needed while considering inotropy; if the right heart pressure is not high and the right heart contraction is poor, enhanced fluid replacement may be required).

[0058] Therefore, in the present invention, based on the right heart hemodynamic classification module, the right heart hemodynamic phenotype is classified according to the degree of influence of the right heart on the left heart, the potential causes of right heart dysfunction, the hemodynamic consequences, the presence of pulmonary hypertension, and the presence of right heart function impairment.

[0059] Example 7 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration based on the above-mentioned embodiment 6. In this embodiment, a second image acquisition module, a second image processing and recognition module and a second index calculation module are also included.

[0060] Among them, the right heart influence on the left heart degree grading module, the right heart dysfunction potential cause classification module, the hemodynamic consequence analysis module, and the pulmonary hypertension identification module can share the second image acquisition module and the second image processing and identification module. The hemodynamic consequence analysis module and the pulmonary hypertension identification module can share the second indicator calculation module.

[0061] The second image acquisition module is used to acquire ultrasound images of the apical five-chamber heart section, the parasternal left ventricular short axis section, and the pulmonary artery long axis / right ventricular outflow tract section through a cardiac ultrasound probe, and is also used to acquire Doppler blood flow spectrum, and transmit the acquired ultrasound images to the second image processing and recognition module.

[0062] The second image processing and recognition module is used to preprocess the received ultrasound images to obtain qualified ultrasound images of each section, and to identify the left ventricular endocardium of the parasternal left ventricular short axis section, the ventricular septum endocardium of the parasternal left ventricular short axis section, the right ventricular endocardium of the parasternal left ventricular short axis section, the root of the apical five-chamber aortic valve, and the pulmonary artery root of the pulmonary artery long axis / right ventricular outflow tract section in the qualified ultrasound images of each section.

[0063] The second index calculation module is used to calculate each second index according to the Doppler blood flow spectrum and the areas identified in the qualified ultrasound images of each section. The second index includes the tricuspid regurgitation pressure difference TR-PG and the second index for judging the hemodynamic consequences.

[0064] Example 8 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration based on the above-mentioned embodiment 6. In this embodiment, the right heart influence on the left heart grading module, the right heart dysfunction potential cause classification module, the hemodynamic consequence analysis module, and the pulmonary hypertension identification module are each separately provided with a second image acquisition module and a second image processing and identification module. The hemodynamic consequence analysis module and the pulmonary hypertension identification module are each separately provided with a second indicator calculation module.

[0065] Specifically, the module for grading the degree of influence of the right heart on the left heart can collect the ultrasonic image of the parasternal left ventricular short-axis section according to the built-in second image acquisition module, and transmit it to the second image processing and recognition module of the module for grading the degree of influence of the right heart on the left heart, and finally identify the morphology and staging of the parasternal left ventricular short-axis ventricular septum.

[0066] The right heart dysfunction potential cause classification module can collect ultrasound images of the parasternal left ventricular short-axis view or the four-chamber heart view according to the built-in second image acquisition module, and transmit it to the second image processing and recognition module of the right heart dysfunction potential cause classification module to identify the ventricular septum endothelium of the parasternal left ventricular short-axis view, the right ventricular free wall endothelium of the four-chamber heart view, and the four-chamber ventricular septum endothelium.

[0067] The pulmonary hypertension identification module can collect Doppler blood flow spectrum according to the second image acquisition module, and the second indicator calculation module of the pulmonary hypertension identification module calculates the tricuspid regurgitation pressure difference TR-PG.

[0068] The hemodynamic consequence analysis module can collect ultrasound images of the apical five-chamber heart section and the pulmonary artery long axis / right ventricular outflow tract section according to the built-in second image acquisition module, and collect Doppler blood flow spectrum diagrams, and transmit them to the second image processing and recognition module of the hemodynamic consequence analysis module to identify the apical five-chamber heart aortic valve root and the pulmonary artery root of the pulmonary artery long axis / right ventricular outflow tract section; finally, according to the second indicator calculation module of the hemodynamic consequence analysis module, calculate the second indicator for judging the hemodynamic consequence.

[0069] Example 9 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration based on the above-mentioned embodiment 6. In this embodiment, a second image acquisition module, a second image processing and recognition module and a second index calculation module are also included.

[0070] Among them, the second image acquisition module can be integrated with the first image acquisition module, so that the integrated image acquisition module can acquire ultrasound images of the transthoracic apical four-chamber view, apical five-chamber view, parasternal left ventricular short-axis view, pulmonary artery long-axis / right ventricular outflow tract view and subcostal four-chamber view through a cardiac ultrasound probe, and acquire Doppler blood flow spectrum.

[0071] The second image processing and recognition module can be integrated with the first image processing and recognition module, so that the integrated image processing and recognition module can recognize the cardiac endothelium and required specific parts in real time: including the left and right ventricular endothelium, left and right atrial endothelium, right ventricular free wall endothelium, ventricular septum endothelium, and the root of the right ventricular free wall ring of the tricuspid valve in the four-chamber heart section; the left ventricular endothelium, ventricular septum endothelium, and right ventricular endothelium in the left ventricular short-axis section; the root of the apical five-chamber aortic valve; the root of the pulmonary artery in the pulmonary artery long-axis / right ventricular outflow tract section.

[0072] The second indicator calculation module can be integrated with the first indicator calculation module, so that the integrated indicator calculation module can calculate the following indicators: left ventricular end-diastolic endocardial area, right ventricular end-diastolic endocardial area, right ventricular free wall thickness, right atrial area, an indicator for judging whether the right heart systolic function is decreased, tricuspid regurgitation pressure gradient TR-PG, and an indicator for judging the hemodynamic consequences.

[0073] Example 10 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the module for grading the degree of influence of the right heart on the left heart on the basis of any one of the above-mentioned embodiments 6 to 9.

[0074] In this embodiment, based on the grading module of the degree of influence of the right heart on the left heart, the degree of influence of the right heart on the left heart can be graded according to the morphology and staging of the ventricular septum in the parasternal left ventricular short axis section. Among them, the grading results of the degree of influence of the right heart on the left heart include normal, mild, moderate and severe. More specifically, if there is no D sign in the ventricular septum in the parasternal left ventricular short axis section, the degree of influence of the right heart on the left heart is normal; if there is jitter in the ventricular septum in the parasternal left ventricular short axis section, the degree of influence of the right heart on the left heart is mild; if there is a diastolic D sign in the ventricular septum in the parasternal left ventricular short axis section, the degree of influence of the right heart on the left heart is moderate; if there is a double-phase D sign in the ventricular septum in the parasternal left ventricular short axis section, the degree of influence of the right heart on the left heart is severe.

[0075] Since the greater the eccentric index value, the greater the right heart pressure, the greater the impact on the left heart. If it is not possible to grade the degree of right heart impact on the left heart based on the morphology and stage of the ventricular septum in the parasternal left ventricular short axis view, the eccentric index calculated from the ventricular septum endothelium in the parasternal left ventricular short axis view can be used to grade the degree of right heart impact on the left heart.

[0076] Embodiment 11 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the module for grading the degree of influence of the right heart on the left heart on the basis of the above-mentioned embodiment 10. Among them, when the diastolic D sign of the ventricular septum in the parasternal left ventricular short-axis view or the double-phase D sign of the ventricular septum in the parasternal left ventricular short-axis view appears, the eccentric index is also calculated through the ventricular septum endothelium of the parasternal left ventricular short-axis view to further judge the degree of influence of the right heart on the left heart. For example, according to the morphology and staging of the ventricular septum in the parasternal left ventricular short-axis view, the degree of influence of the right heart on the left heart is judged to be moderate, and according to the eccentric index, the moderate degree is further graded, for example, it can be moderate one, moderate two or moderate three, etc. Through this refined classification, the effect of auxiliary decision-making in the later stage is better.

[0077] Example 12 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the right heart dysfunction potential cause classification module based on any one of the above embodiments 6 to 11. The potential causes of right heart dysfunction include right heart volume overload and right heart pressure overload. Due to the different pressure distribution in the right ventricle caused by volume overload or pressure overload, the ventricular wall movement during the contraction and diastolic movement presents different states and different movement patterns. For example, when the pressure is overloaded (i.e., pulmonary hypertension), there is a central depression in the ventricular septum. Therefore, the right heart dysfunction potential cause classification module completes the classification of the potential causes of right heart dysfunction, specifically referring to: drawing the parasternal left ventricular short-axis ventricular septum motion trajectory curve based on the parasternal left ventricular short-axis section of the ventricular septum endothelium, or drawing the four-chamber heart right ventricular free wall and ventricular septum motion trajectory curve based on the right ventricular free wall endothelium and the four-chamber ventricular septum endothelium of the four-chamber heart section. By judging the shape of the parasternal left ventricular short-axis ventricular septum motion trajectory curve or the four-chamber right ventricular free wall and ventricular septum motion trajectory curve, it is judged that the potential cause of right heart dysfunction is mainly right heart volume overload or right heart pressure overload (i.e., pulmonary hypertension).

[0078] Example 13 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the hemodynamic consequence analysis module based on any one of the above embodiments 6 to 12. The hemodynamic consequence analysis module is used to judge the impact on right heart output based on the indicators used to judge the hemodynamic consequences. Among them, the indicators used to judge the hemodynamic consequences include: aortic velocity integral AV-VTI, aortic valve stroke volume AV-SV, pulmonary artery velocity time integral PV-VTI and pulmonary artery stroke volume PV-SV. Specifically, the aortic velocity integral AV-VTI and the pulmonary artery velocity time integral PV-VTI can be calculated based on the Doppler blood flow spectrum. Combined with the diameter d1 of the aortic valve root of the apical five-chamber heart and the diameter d2 of the pulmonary artery root in the long axis / right ventricular outflow tract section, the aortic valve stroke volume AV-SV and the pulmonary artery stroke volume PV-SV are calculated respectively. Among them, AV-SV= (AV-VTI)*π*(1 / d1) 2 ;PV-VTI=(PV-VTI)*π*(1 / d2) 2 .

[0079] Embodiment 14 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the pulmonary hypertension identification module based on any one of the above embodiments 6 to 13.

[0080] The pulmonary hypertension identification module compares the calculated tricuspid regurgitation pressure difference TR-PG with the corresponding threshold value. If the tricuspid regurgitation pressure difference TR-PG is higher than the corresponding threshold value, it is determined that pulmonary hypertension exists. The tricuspid regurgitation pressure difference TR-PG can be calculated based on the Doppler blood flow spectrum. This calculation method is a conventional technical means in this field and will not be described in detail in this embodiment.

[0081] If there is no tricuspid regurgitation pressure gradient TR-PG, the motion trajectory of the left ventricular short axis ventricular septum, assisted by the motion trajectory of the right ventricular free wall and ventricular septum of the four-chamber heart, can be used to see whether there are morphological manifestations suggesting pulmonary hypertension. For example, the left ventricular short axis ventricular septum will have a central depression in the case of pulmonary hypertension.

[0082] Embodiment 15 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the right heart hemodynamic classification module based on any one of the above embodiments 6 to 14. The classification of right heart hemodynamic phenotypes specifically includes: acute right heart-induced significant decrease in left ventricular output phenotype mainly caused by pulmonary hypertension, normal left heart output phenotype due to chronic right heart dysfunction, and mild right heart enlargement due to volume overload, resulting in mild decrease in left heart output phenotype, etc.

[0083] More specifically, if the tricuspid regurgitation pressure gradient TR-PG is higher than the corresponding threshold or the potential cause of right heart dysfunction is mainly pressure overload, and there is acute right heart dysfunction, and the degree of influence of the right heart on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and the aortic valve stroke volume AV-SV are both lower than the corresponding threshold, then it is an acute right heart-induced phenotype with a significant decrease in left heart output caused mainly by pulmonary hypertension.

[0084] If the tricuspid regurgitation pressure gradient TR-PG is higher than the corresponding threshold or the potential cause of right heart dysfunction is mainly pressure overload, and there is chronic right heart dysfunction, and the influence of the right heart on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and aortic valve stroke volume AV-SV are higher than the corresponding threshold, then the phenotype of chronic right heart dysfunction and normal left heart output is considered.

[0085] If the potential cause of right heart dysfunction is mainly right heart volume overload, the right ventricle is enlarged, and one or both of the aortic velocity integral AV-VTI and the aortic valve stroke volume AV-SV are lower than the corresponding threshold, then it is a phenotype of mild right heart enlargement caused by volume overload and mild decrease in left heart output.

[0086] Example 16 As another preferred embodiment of the present invention, this embodiment is a further detailed supplement and elaboration of the right heart hemodynamics identification system based on any one of the above embodiments 6 to 15. The right heart hemodynamics identification system also includes an early warning module, which issues a preliminary early warning if there is acute right heart dysfunction; and issues a high level early warning if there is acute right heart dysfunction, and the degree of right heart influence on left heart is moderate or severe, and the aortic velocity integral AV-VTI and aortic valve stroke volume AV-SV are both lower than the corresponding thresholds.

[0087] Embodiment 17 As another preferred embodiment of the present invention, the present invention includes an auxiliary decision-making system, which assists decision-making based on the classification results of the right heart hemodynamic phenotype by the right heart hemodynamic identification system in the above-mentioned Example 15. More specifically, if the right heart hemodynamic phenotype is an acute right heart-derived phenotype with a significant decrease in left ventricular output mainly caused by pulmonary hypertension, it is suggested that the treatment is mainly to screen the causes of increased right heart afterload, evaluate the lungs and pulmonary blood vessels, and relieve obstruction; if the right heart hemodynamic phenotype is a phenotype of normal left heart output due to chronic right heart dysfunction, it is suggested that the treatment is mainly to carefully manage fluid output, closely monitor dynamic change trends, and issue early warnings; if the right heart hemodynamic phenotype is a phenotype of a slight decrease in left heart output caused by a slight increase in the right heart due to volume overload, it is suggested that the treatment is mainly to dehydrate and diuresis.

[0088] In summary, after reading the present invention document, ordinary technicians in this field can make various other corresponding transformation schemes based on the technical scheme and technical concept of the present invention without creative mental labor, which all fall within the scope of protection of the present invention.

Claims

1. Right heart dysfunction identification system, characterized by: include A first image acquisition module, used for acquiring ultrasound images of different sections of the heart through a cardiac ultrasound probe, and transmitting the images to a first image processing and recognition module; The first image processing and recognition module is used to pre-process the received ultrasound images to obtain qualified ultrasound images of each section, and identify the left ventricular endocardium of the four-chamber heart section, the right ventricular endocardium of the four-chamber heart section, the right atrial endocardium of the four-chamber heart section, the left atrial endocardium of the four-chamber heart section, the right ventricular free wall endocardium of the four-chamber heart section, the four-chamber ventricular septum endocardium and the root of the right ventricular free wall annulus of the tricuspid valve in the qualified ultrasound images of each section; a first indicator calculation module and / or a sign recognition module, wherein the sign recognition module is used to identify each sign according to the area identified in the qualified ultrasound image of each section; the first indicator calculation module is used to calculate the first indicator corresponding to each sign according to the area identified in the qualified ultrasound image of each section; the signs include whether the right ventricular free wall is thickened, whether the right atrium is enlarged, whether the right ventricle is enlarged, and whether the right heart contraction function is decreased; The right heart dysfunction identification and classification module is used to identify each sign based on the signs identified by the sign identification module; or / and based on the first indicator calculated by the first indicator calculation module; and to identify whether there is right heart dysfunction and classify the acuteness or chronicity of the dysfunction.

2. The right heart dysfunction identification system according to claim 1, characterized in that: The different heart sections include the transthoracic apical four-chamber heart section and / or the subcostal four-chamber heart section.

3. The right heart dysfunction identification system according to claim 1, characterized in that: The first indicator corresponding to whether the right ventricular free wall is thickened includes the right ventricular free wall thickness; the first indicator corresponding to whether the right atrium is enlarged includes the right atrium area; the first indicator corresponding to whether the right ventricle is enlarged includes the left ventricular end-diastolic endocardial area and the right ventricular end-diastolic endocardial area.

4. The right heart dysfunction identification system according to claim 3, characterized in that: The specific calculation methods of each first indicator include: calculating the left ventricular end-diastolic endocardial area based on the left ventricular endocardium in the four-chamber heart view, calculating the right ventricular end-diastolic endocardial area based on the right ventricular endocardium in the four-chamber heart view; calculating the right ventricular free wall thickness based on the right ventricular free wall endocardium in the four-chamber heart view; calculating the right atrial area based on the right atrial endocardium in the four-chamber heart view.

5. The right heart dysfunction identification system according to claim 1, characterized in that: The first indicators corresponding to whether the right heart systolic function is decreased include tricuspid valve annulus root displacement TAPSE, right ventricular area change rate RV-FAC, right ventricular free wall contraction rate and right ventricular septum contraction rate.

6. The right heart dysfunction identification system according to claim 5, characterized in that: The specific calculation method of the first indicator corresponding to whether the right heart systolic function is decreased includes: calculating the tricuspid valve annulus root displacement TAPSE based on the tricuspid valve right ventricular free wall annulus root; calculating the right ventricular area change rate RV-FAC based on the right ventricular endocardium in the four-chamber heart section; calculating the right ventricular free wall contraction rate based on the right ventricular free wall endocardium; calculating the right ventricular septum contraction rate based on the four-chamber ventricular septum endocardium.

7. The right heart dysfunction identification system according to claim 5, characterized in that: If the tricuspid valve annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall contraction rate and the right ventricular septum contraction rate are all higher than the corresponding upper limit thresholds, it is judged that the right heart systolic function has not declined; if one or more of the tricuspid valve annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall contraction rate and the right ventricular septum contraction rate are lower than the corresponding lower limit threshold, it is judged that the right heart systolic function has declined.

8. The right heart dysfunction identification system according to claim 1, characterized in that: Identify whether there is right heart function impairment and classify the acuteness or chronicity of the impairment, specifically: If the right ventricle is not enlarged, the right atrium is not enlarged, the right ventricular free wall is not thickened, and the right heart systolic function is not decreased, it is identified as no obvious abnormality in right heart function; If the right ventricle is enlarged and the right heart systolic function is decreased, and the right ventricular free wall is not thickened, and the right atrium is not enlarged, it is identified as acute right heart dysfunction; if the right ventricle is enlarged and the right ventricular free wall is thickened or the right atrium is enlarged and the right heart systolic function is decreased, it is identified as chronic right heart dysfunction or chronic right heart dysfunction + acute exacerbation. 9.Right heart hemodynamics identification system, characterized by: It includes a module for grading the degree of influence of the right heart on the left heart, a module for classifying potential causes of right heart dysfunction, a module for analyzing hemodynamic consequences, a module for identifying pulmonary hypertension, a module for classifying right heart hemodynamics, and a right heart dysfunction identification system as described in any one of claims 1 to 8 above; the module for grading the degree of influence of the right heart on the left heart is used to obtain a grading result of the degree of influence of the right heart on the left heart; the module for classifying potential causes of right heart dysfunction is used to obtain a classification result of the potential causes of right heart dysfunction; the module for analyzing hemodynamic consequences is used to judge the hemodynamic consequences; the module for identifying pulmonary hypertension is used to judge whether there is pulmonary hypertension; the module for classifying right heart hemodynamics is used to classify the right heart hemodynamic phenotype according to the grading result of the degree of influence of the right heart on the left heart, the classification result of the potential causes of right heart dysfunction, the hemodynamic consequences, whether there is pulmonary hypertension, and whether there is right heart function disorder and the acuteness and chronicity of the disorder.

10. The right heart hemodynamics identification system according to claim 9, characterized in that: It also includes a second image acquisition module, a second image processing and recognition module and a second index calculation module; the second image acquisition module is used to acquire ultrasound images of different sections of the heart through a cardiac ultrasound probe, and transmit them to the second image processing and recognition module, and is also used to acquire Doppler blood flow spectrum diagram; the second image processing and recognition module is used to pre-process the received ultrasound images to obtain qualified ultrasound images of each section, and identify the left ventricular endocardium of the parasternal left ventricular short axis section, the ventricular septum endocardium of the parasternal left ventricular short axis section, the right ventricular endocardium of the parasternal left ventricular short axis section, the root of the apical five-chamber aortic valve, and the root of the pulmonary artery in the pulmonary artery long axis / right ventricular outflow tract section in the qualified ultrasound images of each section; the second index calculation module is used to calculate each second index according to the Doppler blood flow spectrum diagram and the areas identified in the qualified ultrasound images of each section; the second index includes the tricuspid regurgitation pressure difference TR-PG and a second index for judging the hemodynamic consequences.

11. The right heart hemodynamics identification system according to claim 10, characterized in that: Different views of the heart include the apical five-chamber view, the parasternal left ventricular short-axis view, and the pulmonary artery long-axis / right ventricular outflow tract view.

12. The right heart hemodynamics identification system according to claim 10, characterized in that: The second indexes used to judge the hemodynamic consequences include: aortic velocity integral AV-VTI, aortic valve stroke volume AV-SV, pulmonary artery velocity time integral PV-VTI and pulmonary artery stroke volume PV-SV.

13. The right heart hemodynamics identification system according to claim 10, characterized in that: The module for grading the degree of influence of the right heart on the left heart is used to obtain the grading result of the degree of influence of the right heart on the left heart, specifically referring to: grading the degree of influence of the right heart on the left heart according to the morphology and staging of the ventricular septum in the parasternal left ventricular short-axis view or / and the eccentric index calculated based on the ventricular septum endothelium in the parasternal left ventricular short-axis view.

14. The right heart hemodynamics identification system according to claim 13, characterized in that: The degree of influence of the right heart on the left heart is graded as normal, mild, moderate, and severe.

15. The right heart hemodynamics identification system according to claim 14, characterized in that: If there is no D sign in the ventricular septum on the parasternal left ventricular short-axis view, the degree of influence of the right heart on the left heart is normal; If the ventricular septum jitter occurs in the parasternal left ventricular short-axis view, the influence of the right heart on the left heart is mild; if the ventricular septum diastolic D sign occurs in the parasternal left ventricular short-axis view, the influence of the right heart on the left heart is moderate; if the ventricular septum double-phase D sign occurs in the parasternal left ventricular short-axis view, the influence of the right heart on the left heart is severe.

16. The right heart hemodynamics identification system according to claim 15, characterized in that: When the diastolic D sign of the ventricular septum in the parasternal left ventricular short-axis view or the double-phase D sign of the ventricular septum in the parasternal left ventricular short-axis view appears, the eccentric index is calculated through the ventricular septum endothelium of the parasternal left ventricular short-axis view to further determine the degree of influence of the right heart on the left heart.

17. The right heart hemodynamics identification system according to claim 10, characterized in that: The right heart dysfunction potential cause classification module is used to complete the classification of potential causes of right heart dysfunction, specifically referring to: drawing a parasternal left ventricular short-axis ventricular septum motion trajectory curve based on the parasternal left ventricular short-axis section ventricular septum endothelium, or drawing a four-chamber heart right ventricular free wall and ventricular septum motion trajectory curve based on the right ventricular free wall endothelium and the four-chamber heart ventricular septum endothelium; judging whether the potential cause of right heart dysfunction is mainly right heart volume overload or right heart pressure overload through the morphology of the parasternal left ventricular short-axis ventricular septum motion trajectory curve or the four-chamber heart right ventricular free wall and ventricular septum motion trajectory curve.

18. The right heart hemodynamics identification system according to claim 9, characterized in that: The classification of right heart hemodynamic phenotypes specifically includes: acute right heart-related phenotype with a significant decrease in left ventricular output caused mainly by pulmonary hypertension, normal left heart output phenotype caused by chronic right heart dysfunction, and mild right heart enlargement caused by volume overload, resulting in a mild decrease in left heart output phenotype.

19. The right heart hemodynamics identification system according to claim 18, characterized in that: If the tricuspid regurgitation pressure gradient TR-PG is higher than the corresponding threshold or the potential cause of right heart dysfunction is mainly pressure overload, and there is acute right heart dysfunction, and the degree of right heart influence on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and aortic valve stroke volume AV-SV are both lower than the corresponding threshold, then it is an acute right heart-induced phenotype with a significant decrease in left heart output caused mainly by pulmonary hypertension; If the tricuspid regurgitation pressure gradient TR-PG is higher than the corresponding threshold or the potential cause of right heart dysfunction is mainly pressure overload, and there is chronic right heart dysfunction, and the degree of right heart influence on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and aortic valve stroke volume AV-SV are higher than the corresponding threshold, then the phenotype of chronic right heart dysfunction and normal left heart output is considered; If the potential cause of right heart dysfunction is right heart volume overload, the right ventricle is enlarged, and one or both of the aortic flow velocity integral AV-VTI and the aortic valve stroke volume AV-SV are lower than the corresponding threshold, it is a phenotype of mild right heart enlargement caused by mild decrease in left heart output due to volume overload.

20. The right heart hemodynamics identification system according to claim 19, characterized in that: It also includes an early warning module, which issues a preliminary early warning if acute right heart dysfunction exists; if acute right heart dysfunction exists and the degree of influence of the right heart on the left heart is moderate or severe, and the aortic flow velocity integral AV-VTI and the aortic valve stroke volume AV-SV are both lower than the corresponding thresholds, a high early warning is issued.

21. A decision support system, characterized in that: Based on the classification results of the right heart hemodynamic phenotype by the right heart hemodynamic identification system described in claim 18, auxiliary decision-making is performed.

22. A decision support system according to claim 21, characterized in that: The auxiliary decision specifically refers to: if the right heart hemodynamic phenotype is an acute right heart-derived phenotype with a significant decrease in left ventricular output caused mainly by pulmonary hypertension, then the treatment is mainly to screen the causes of increased right heart afterload, evaluate the lungs and pulmonary blood vessels, and relieve obstruction; if the right heart hemodynamic phenotype is a chronic right heart dysfunction phenotype with normal left heart output, then the treatment is mainly to carefully manage fluid output, closely monitor dynamic change trends, and provide early warnings; If the right heart hemodynamic phenotype is mainly volume overload with mild right heart enlargement causing mild decrease in left heart output, then the treatment is mainly dehydration and diuresis.

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