Right heart dysfunction identification, right heart hemodynamics identification, and assisted decision system

Abstract

The present application relates to medical information collection technical field, more specifically to right heart dysfunction identification, right heart hemodynamics identification and auxiliary decision system, right heart dysfunction identification system includes first image acquisition module, first image processing and identification module, first index calculation module or / and sign identification module and right heart dysfunction identification classification module, the right heart hemodynamics identification system includes right heart influence degree grading module to left heart, right heart dysfunction potential reason classification module, blood flow dynamics consequence analysis module, pulmonary arterial hypertension identification module, right heart hemodynamics classification module and above-mentioned right heart dysfunction identification system, through the above-mentioned system, through the information of right heart structured arrangement, can complete right heart dysfunction identification, and can identify the phenotype of right ventricular protection hemodynamics, and then can give the relevant diagnosis and treatment decision suggestion.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of medical information collection, more particularly to right heart dysfunction identification, right heart hemodynamics identification and auxiliary decision system. BACKGROUND

[0002] It is generally believed that the left heart is the key to determine cardiac output, arterial blood pressure, tissue perfusion and maintain effective circulation, and the development of bedside hemodynamic monitoring means and advanced visualization technology confirms that the right heart also plays an important role in cardiovascular homeostasis, not less than the left heart. Especially for critically ill patients, various factors can cause acute right heart dysfunction, and the afterload is mainly increased. Among the patients with acute respiratory distress syndrome (ARDS) undergoing mechanical ventilation, 14%-50% of them develop acute pulmonary heart disease (ACP), and most of them are about 25%, and acute right heart dysfunction is closely related to the poor prognosis of ICU patients. Due to its unique myocardial structure and configuration, position in circulation, and some special nature of 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 two-layer oblique muscle structure of the right heart leads to good volume tolerance and poor pressure tolerance, and when the pulmonary circulation is problematic, it is easy to cause acute right heart function progressive failure; ICU patients are prone to respiratory dysfunction, which can cause pulmonary circulation to spasm, contract and meander, thereby causing the right heart afterload to increase and acute right heart dysfunction to occur frequently. Due to the fact that the right heart is at the end of systemic venous return and the source of left heart volume, once right heart dysfunction occurs, on the one hand, it will lead to insufficient left heart volume, and once it affects left heart contraction through the interventricular septum, it will further reduce 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 joint for the deterioration of ICU patients. Therefore, inexperienced doctors are prone to miss right heart-related information when, for example, performing shock diagnosis and treatment programs, and are disturbed by other clinical information, which affects the timeliness and standardization of diagnosis and treatment.

[0003] The advent of critical care ultrasound has made the assessment of right ventricular function more convenient, real-time, non-invasive, and accurate. Key indicators of right ventricular systolic function include right ventricular ejection fraction (RVEF), rate of change of area (FAC), tricuspid annular root displacement (TAPSE), stroke volume (SV), and tricuspid regurgitation pressure gradient (which indirectly reflects pulmonary artery pressure). Right ventricular contraction primarily involves longitudinal shortening via peristalsis; therefore, using the longitudinal displacement of the tricuspid annular root to represent right ventricular contraction is considered reliable. Furthermore, based on critical care ultrasound assessment results, not only can real-time monitoring and early warning be provided, but right ventricular hemodynamic phenotypes can also be classified and even used to guide clinical diagnosis and treatment, improving prognosis. This can be applied in various scenarios such as shock treatment, mechanical ventilation parameter adjustment, and high-altitude pulmonary edema. However, current critical care ultrasound assessment requires specialized training and is highly dependent on clinicians' knowledge, skills, and experience in critical care ultrasound and critical right ventricular hemodynamics, making it easily overlooked in clinical practice. Summary of the Invention

[0004] To overcome the defects and deficiencies in the existing technologies, this invention provides a system for identifying right ventricular dysfunction, identifying right ventricular hemodynamics, and providing auxiliary decision-making based on right ventricular protection. By structuring and organizing the information of the right ventricle, it completes the identification of right ventricular dysfunction and can identify the hemodynamic phenotype of right ventricular protection, thereby providing relevant diagnostic and treatment decision-making suggestions and filling the current gap in real-time monitoring of right ventricular hemodynamics.

[0005] This invention is achieved by adopting the following technical solution:

[0006] Right heart dysfunction identification system, including

[0007] 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.

[0008] The first 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 endocardium, right endocardium, right atrial endocardium, left atrial endocardium, right ventricular free wall endocardium, 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.

[0009] The first indicator calculation module and / or the sign recognition module are used to identify each sign based on the regions identified in the qualified ultrasound images of each section; the first indicator calculation module is used to calculate the first indicator corresponding to each sign based on the regions identified in the qualified ultrasound images 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 ventricular systolic function is decreased.

[0010] The right heart dysfunction identification and classification module is configured to identify each sign according to the signs identified by the sign identification module, or / and identify each sign according to the first indexes calculated by the first index calculation module, and identify whether the right heart function has a dysfunction, and classify the acuteness of the dysfunction.

[0011] The different heart sections include a transthoracic apical four-chamber heart section and / or an infraxiphoid four-chamber heart section.

[0012] The first index corresponding to whether the right ventricular free wall is thickened includes a right ventricular free wall thickness, the first index corresponding to whether the right atrium is enlarged includes a right atrial area, and the first index corresponding to whether the right ventricle is enlarged includes a left ventricular end-diastolic endocardial area and a right ventricular end-diastolic endocardial area.

[0013] The specific calculation method of each first index includes calculating a left ventricular end-diastolic endocardial area according to a left ventricular endocardium of the four-chamber heart section, calculating a right ventricular end-diastolic endocardial area according to a right ventricular endocardium of the four-chamber heart section, calculating a right ventricular free wall thickness according to a right ventricular free wall endocardium of the four-chamber heart section, and calculating a right atrial area according to a right atrial endocardium of the four-chamber heart section.

[0014] The first index corresponding to whether the right heart systolic function is decreased includes a tricuspid annulus root displacement TAPSE, a right ventricular fractional area change RV-FAC, a right ventricular free wall systolic rate, and a right ventricular septal systolic rate.

[0015] The specific calculation method of the first index corresponding to whether the right heart systolic function is decreased includes calculating a tricuspid annulus root displacement TAPSE according to a tricuspid right ventricular free wall annulus root, calculating a right ventricular fractional area change RV-FAC according to a right ventricular endocardium of the four-chamber heart section, calculating a right ventricular free wall systolic rate according to a right ventricular free wall endocardium, and calculating a right ventricular septal systolic rate according to a four-chamber ventricular septal endocardium.

[0016] If the tricuspid annulus root displacement TAPSE, the right ventricular fractional area change RV-FAC, the right ventricular free wall systolic rate, and the right ventricular septal systolic rate are all higher than the corresponding upper threshold values, it is determined that the right heart systolic function is not decreased; if one or more of the tricuspid annulus root displacement TAPSE, the right ventricular fractional area change RV-FAC, the right ventricular free wall systolic rate, and the right ventricular septal systolic rate are lower than the corresponding lower threshold values, it is determined that the right heart systolic function is decreased.

[0017] The identification of right ventricular dysfunction is performed, and the acuteness or chronicity of the dysfunction is classified as follows: If there is no enlargement of the right ventricle, the right atrium, the right ventricular free wall, and the right ventricular systolic function is not decreased, it is identified as no obvious abnormality in right ventricular function; if there is enlargement of the right ventricle, the right ventricular 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 ventricular dysfunction; if there is enlargement of the right ventricle, the right ventricular free wall is thickened, or the right atrium is enlarged, and the right ventricular systolic function is decreased, it is identified as chronic right ventricular dysfunction or chronic right ventricular dysfunction with acute exacerbation.

[0018] A right ventricular hemodynamic identification system includes a grading module for the degree of right ventricular influence on the left ventricular, a classification module for potential causes of right ventricular dysfunction, a hemodynamic consequence analysis module, a pulmonary hypertension identification module, a right ventricular hemodynamic classification module, and a right ventricular dysfunction identification system. The grading module for the degree of right ventricular influence on the left ventricular is used to obtain a grading result of the degree of influence of the right ventricular on the left ventricular. The classification module for potential causes of right ventricular dysfunction is used to obtain a classification result of potential causes of right ventricular dysfunction. The hemodynamic consequence analysis module is used to determine the hemodynamic consequences. The pulmonary hypertension identification module is used to determine whether pulmonary hypertension exists. The right ventricular hemodynamic classification module is used to classify the right ventricular hemodynamic phenotype based on the grading result of the degree of right ventricular influence on the left ventricular, the classification result of potential causes of right ventricular dysfunction, the hemodynamic consequences, the presence of pulmonary hypertension, and the presence and acute / chronicity of right ventricular dysfunction.

[0019] 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. It is also used to acquire Doppler blood flow spectrum maps. The second image processing and recognition module is used to preprocess the received ultrasound images to obtain qualified ultrasound images of each section. In the qualified ultrasound images of each section, it identifies the left endocardium in the parasternal left ventricular short-axis section, the interventricular septum in the parasternal left ventricular short-axis section, the right endocardium in the parasternal left ventricular short-axis section, the aortic valve root in the apical five-chamber heart, and the pulmonary artery root in the pulmonary artery long-axis / right ventricular outflow tract section. The second index calculation module is used to calculate each second index based on the regions identified in the Doppler blood flow spectrum map and the qualified ultrasound images of each section. The second index includes the tricuspid regurgitation pressure gradient (TR-PG) and a second index used to determine the hemodynamic consequences.

[0020] Different sections 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.

[0021] The second index for judging hemodynamic consequences includes: 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.

[0022] The right heart impact on left heart degree grading module is used to obtain a grading result of the right heart impact on the left heart, and specifically refers to grading the right heart impact on the left heart according to the interventricular septum morphology and stage of the parasternal left ventricular short-axis view or / and the centrifugal index calculated according to the endometrium of the parasternal left ventricular short-axis view.

[0023] The grading result of the right heart impact on the left heart includes normal, mild, moderate, and severe.

[0024] If there is no D sign of the parasternal left ventricular short-axis view interventricular septum, the right heart impact on the left heart is normal; if there is flutter of the parasternal left ventricular short-axis view interventricular septum, the right heart impact on the left heart is mild; if there is diastolic D sign of the parasternal left ventricular short-axis view interventricular septum, the right heart impact on the left heart is moderate; and if there is double-phase D sign of the parasternal left ventricular short-axis view interventricular septum, the right heart impact on the left heart is severe.

[0025] When there is diastolic D sign of the parasternal left ventricular short-axis view interventricular septum or double-phase D sign of the parasternal left ventricular short-axis view interventricular septum, the centrifugal index is calculated according to the endometrium of the parasternal left ventricular short-axis view interventricular septum to further judge the right heart impact on the left heart.

[0026] The right heart dysfunction potential cause classification module is used to complete classification of the right heart dysfunction potential cause, and specifically refers to drawing a parasternal left ventricular short-axis interventricular septum motion trajectory curve according to the endometrium of the parasternal left ventricular short-axis view interventricular septum, or drawing a four-chamber heart right ventricular free wall and interventricular septum motion trajectory curve according to the endometrium of the four-chamber heart interventricular septum; and judging whether the right heart dysfunction potential cause is mainly right heart volume overload or mainly right heart pressure overload according to the shape of the parasternal left ventricular short-axis interventricular septum motion trajectory curve or the four-chamber heart right ventricular free wall and interventricular septum motion trajectory curve.

[0027] The classification of the right heart hemodynamic phenotype specifically includes: an acute right heart source type left ventricular output significantly decreased phenotype mainly caused by pulmonary hypertension, a left ventricular output normal phenotype of chronic right heart dysfunction, and a left ventricular output slightly decreased phenotype mainly caused by volume overload of the slightly enlarged right heart.

[0028] If the tricuspid regurgitation pressure difference TR-PG is higher than the corresponding threshold value 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 value, it is the acute right heart caused by the main cause of pulmonary hypertension leading to significant decrease in left ventricular output phenotype;

[0029] If the tricuspid regurgitation pressure difference TR-PG is higher than the corresponding threshold value or the potential cause of right heart dysfunction is mainly pressure overload, and there is chronic 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 higher than the corresponding threshold value, it is the chronic right heart dysfunction left ventricular output normal phenotype.

[0030] If the potential cause of right heart dysfunction is mainly right heart volume overload, and 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 value, it is the right heart mild enlargement caused by volume overload leading to mild decrease in left ventricular output phenotype, etc.

[0031] It also includes a warning module, if there is acute right heart dysfunction, a preliminary warning is issued; if 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 value, a high warning is issued.

[0032] An auxiliary decision-making system based on the classification results of the right heart blood flow hemodynamics recognition system to the right heart blood flow hemodynamics phenotype for auxiliary decision-making.

[0033] The auxiliary decision-making specifically refers to: if the right heart blood flow hemodynamics phenotype is the acute right heart caused by the main cause of pulmonary hypertension leading to significant decrease in left ventricular output phenotype, it is suggested that the treatment is mainly to screen the cause of right heart afterload increase, evaluate the lung and pulmonary vessels, and remove the obstruction; if the right heart blood flow hemodynamics phenotype is the chronic right heart dysfunction left ventricular output normal phenotype, it is suggested that the treatment is mainly to cautiously manage liquid output, closely monitor the dynamic change trend, and give early warning; if the right heart blood flow hemodynamics phenotype is the right heart mild enlargement caused by volume overload leading to mild decrease in left ventricular output phenotype, it is suggested that the treatment is mainly to dehydrate and diurese.

[0034] Compared with the prior art, the beneficial effects of the present application are:

[0035] 1. This invention proposes a right ventricular dysfunction identification system, which can structurally organize right ventricular information to identify and classify right ventricular dysfunction as acute or chronic. This addresses the difficulty in identifying right ventricular dysfunction compared to the left ventricular dysfunction due to the right ventricular's more specific needs, unique characteristics, and assessment challenges. Based on this system, medical staff can quickly provide data support during assisted diagnosis, facilitating clinical interpretation of right ventricular dysfunction. The system is faster, requires no specialized training, and avoids delays and non-standard treatments that may occur when medical staff implement shock treatment protocols. It also solves the problem of easily overlooking relevant right ventricular information.

[0036] 2. In this invention, when collecting data, it is only necessary to collect transthoracic apical four-chamber view and / or subxiphoid four-chamber view and parasternal short-axis view ultrasound images. Subsequent identification and parameter calculation are completed automatically, making data collection simpler.

[0037] 3. In this invention, the tricuspid valve annulus root displacement (TAPSE), right ventricular area change rate (RV-FAC), right ventricular free wall contraction rate, and right ventricular septal contraction rate are used to comprehensively determine whether right ventricular systolic function is declining. The judgment results are more accurate and facilitate the improvement of the accuracy of right ventricular dysfunction identification.

[0038] 4. In this invention, the presence of right ventricular dysfunction is comprehensively determined by changes in right ventricular area, right atrial area in four-chamber heart, right ventricular wall thickness in subxiphoid four-chamber heart, and right ventricular systolic function. The acute and chronic nature of the dysfunction is also classified, making the identification and classification results more accurate.

[0039] 5. In this invention, right ventricular hemodynamic phenotypes are classified based on different types of right ventricular dysfunction, the degree of right ventricular influence on the left ventricular, potential causes of right ventricular dysfunction, hemodynamic consequences, and the presence of pulmonary hypertension. Through the interaction of these factors, the classification of right ventricular hemodynamic phenotypes is more accurate, solving the problem of difficulty in right ventricular assessment. It can clearly identify the main causes of hemodynamic disturbances in critically ill patients and fill the current gap in real-time monitoring of right ventricular hemodynamics.

[0040] 6. In this invention, the degree of influence of the right ventricle on the left ventricle is further differentiated by calculating the eccentricity index, resulting in more accurate auxiliary decision-making in the later stages. When the morphology and stage of the interventricular septum in the short-axis section of the left ventricle cannot be determined, the eccentricity index can also be used directly to classify the degree of influence of the right ventricle on the left ventricle.

[0041] 7. This invention, through the morphology of the short-axis interventricular septum motion trajectory curve of the left ventricle or the motion trajectory curve of the free wall and interventricular septum of the right ventricle in a four-chamber heart, can more intuitively observe the ventricular wall motion during systole and diastole, and can better determine the potential causes of right ventricular dysfunction.

[0042] 8. The application further provides an auxiliary decision system, which is based on the classification result of the right heart hemodynamics phenotype of the right heart hemodynamics identification system, and can further give relevant diagnosis and treatment decision suggestions to guide medical personnel to carry out targeted treatment. BRIEF DESCRIPTION OF DRAWINGS

[0043] The application will be further described in detail below with reference to the accompanying drawings and specific embodiments, in which:

[0044] Figure 1 FIG. 1 is a structural schematic diagram of a right heart hemodynamics identification system in the application. DETAILED DESCRIPTION

[0045] Embodiment 1

[0046] As the basic embodiment of the application, the application comprises a right heart dysfunction identification system, which comprises:

[0047] A first image acquisition module is configured to acquire ultrasound images of different sections of a heart by a heart ultrasound probe, and transmit the ultrasound images to a first image processing and identification module.

[0048] The first image processing and identification module is configured to pre-process the received ultrasound images to obtain qualified ultrasound images of each section, and identify the following regions in the qualified ultrasound images of each section: left ventricular endocardium in the four-chamber heart section, right ventricular endocardium in the four-chamber heart section, right atrial endocardium in the four-chamber heart section, left atrial endocardium in the four-chamber heart section, right ventricular free wall endocardium in the four-chamber heart section, interventricular septum endocardium, and tricuspid valve right ventricular free wall annulus root.

[0049] A first index calculation module or / and a sign identification module is provided. The sign identification module is configured to identify signs according to the regions identified in the qualified ultrasound images of each section. The first index calculation module is configured to calculate first indexes corresponding to the signs according to the regions identified in the qualified ultrasound images 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 systolic function is decreased.

[0050] A right heart dysfunction identification and classification module is configured to identify the signs according to the signs identified by the sign identification module, or / and the first indexes calculated by the first index calculation module, and identify whether the right heart has dysfunction and classify the acuteness of the dysfunction.

[0051] Embodiment 2

[0052] As a preferred embodiment of the present application, the embodiment is a further detailed supplement and elaboration of the first image acquisition module and the first image processing and recognition module based on the above-mentioned embodiment 1. In the embodiment, the cardiac ultrasound probe can be a cardiac adhesive / patch / dress probe or a cardiac implanted probe. When the cardiac ultrasound probe is a trans-thoracic cardiac adhesive probe, it can be fixed on the examinee's body in a adhesive or wearable manner. When the cardiac ultrasound probe is a cardiac implanted probe, it can be fixed on the examinee's body in an esophageal implanted manner.

[0053] In the embodiment, the pre-processing of the received ultrasound image can adopt conventional technical means in the art, for example, it can include processing the collected ultrasound images of different sections of the heart into ultrasound images frame by frame respectively, and performing image noise reduction and data enhancement processing on all the ultrasound images. The image noise reduction and data enhancement are also conventional technical means in the art, and will not be described in detail in the embodiment.

[0054] The processed ultrasound images are filtered according to the standard of different sections of the heart ultrasound images by using the pre-trained cardiac section ultrasound qualified image classification model. The section ultrasound qualified image classification model is trained based on the research in the prior art, wherein for each section ultrasound image, a section ultrasound qualified image classification model is trained. The model used for training can be Unet, Inception V3, ResNet50, LeNet-5, etc. The present application does not limit this.

[0055] The filtered qualified ultrasound images are segmented by using the pre-trained cardiac section ultrasound image recognition model, the regions of interest in the qualified ultrasound images of different sections are segmented, and the different regions of interest are recognized and labeled. The cardiac section ultrasound image recognition model can be a neural network model, and the present application does not limit this. The training method is also a conventional technical means in the art, and the present application does not limit it.

[0056] Specifically, the first image acquisition module can obtain the ultrasound images of the trans-thoracic apical four-chamber view and / or the subxiphoid four-chamber view. The first image processing and recognition module can identify and label the left ventricular endocardium, the right ventricular endocardium, the right atrial endocardium, the left atrial endocardium, the right ventricular free wall endocardium, the interventricular septum endocardium, and the tricuspid valve right ventricular free wall annulus root in the trans-thoracic apical four-chamber view and / or the subxiphoid four-chamber view.

[0057] Embodiment 3

[0058] As another preferred embodiment of the present application, the embodiment is a further detailed supplement and elaboration of the first index calculation module and the sign identification module based on the above-mentioned embodiment 1 or embodiment 2. Among them, the right heart dysfunction identification system can have both the first index calculation module and the sign identification module, or only one of the two.

[0059] When the right heart dysfunction identification system only includes the first index calculation module, the first index calculation module is used to calculate the first index corresponding to each sign according to the identified area in the qualified ultrasound image of each section. The first index includes the first index corresponding to whether the right ventricular free wall is thickened, the first index corresponding to whether the right atrium is enlarged, the first index corresponding to whether the right ventricle is enlarged, and the first index corresponding to whether the right heart systolic function is decreased. Among them, the first index corresponding to whether the right ventricular free wall is thickened includes the right ventricular free wall thickness; the first index corresponding to whether the right atrium is enlarged includes the right atrial area; the first index corresponding to whether the right ventricle is enlarged includes the left ventricular end-diastolic intimal area and the right ventricular end-diastolic intimal area. The first index corresponding to whether the right heart systolic function is decreased includes the tricuspid annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall contraction rate, and the right ventricular septal contraction rate.

[0060] When the right heart dysfunction identification system only includes the sign identification module, each sign can be identified according to the identified area in the qualified ultrasound image of each section. The sign identification module can include a pre-trained classification model of each sign. The neural network model used to train the classification model for identifying each sign can be Inception V3, ResNet50, LeNet-5, etc. The present application does not limit this.

[0061] When the right heart dysfunction identification system includes both the first index calculation module and the sign identification module, they can be complementary according to the needs and convenience, etc.

[0062] Embodiment 4

[0063] As another preferred embodiment of the present application, the embodiment is a further detailed supplement and elaboration of the first index calculation module based on the above-mentioned embodiment 3. The embodiment can calculate the left ventricular end-diastolic endocardial area according to the labeled four-chamber heart section left ventricular endocardium, calculate the right ventricular end-diastolic endocardial area according to the four-chamber heart section right ventricular endocardium. Calculate the right ventricular free wall thickness according to the labeled four-chamber heart section right ventricular free wall endocardium. Calculate the right atrial area according to the labeled four-chamber heart section right atrial endocardium. Calculate the tricuspid valve annulus root displacement TAPSE according to the labeled tricuspid valve right ventricular free wall annulus root. Calculate the right ventricular area change rate RV-FAC according to the labeled four-chamber heart section right ventricular endocardium. Calculate the right ventricular free wall contraction rate according to the labeled right ventricular free wall endocardium. Calculate the right ventricular septum contraction rate according to the labeled four-chamber ventricular septum endocardium.

[0064] Embodiment 5

[0065] As another preferred embodiment of the present application, the embodiment is a further detailed supplement and elaboration of the right heart dysfunction identification and classification module based on any one of the above-mentioned embodiments 1-4. The right heart dysfunction identification and classification module identifies whether the right heart function has dysfunction, and classifies the acute and chronic of the dysfunction, specifically:

[0066] If the right ventricle is not enlarged, and the right atrium is not enlarged, and the right ventricular free wall is not thickened, and the right heart systolic function is not decreased, it is identified as no obvious abnormality of 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.

[0067] Among them, whether the right ventricle is enlarged can be identified by the sign identification module; or identified by the left ventricular end-diastolic endocardial area and the right ventricular end-diastolic endocardial area calculated by the first index calculation module. Specifically, whether the right ventricle is enlarged can be determined by the ratio of the left ventricular end-diastolic endocardial area to the right ventricular end-diastolic endocardial area. If the ratio is less than a threshold A1, it is determined that the right ventricle is not enlarged, and if the ratio is greater than a threshold A2, it is determined that the right ventricle is enlarged. Wherein, A1 is less than A2, in this embodiment, A1 can be 0.6, and A2 can be 1.

[0068] Whether the right atrium is enlarged can be identified by the sign identification module; or determined by the four-chamber heart right atrial area calculated by the first index calculation module. If the four-chamber heart right atrial area is less than the corresponding threshold, i.e. the right atrium is not enlarged, if the four-chamber heart right atrial area is greater than the corresponding threshold, i.e. the right atrium is enlarged.

[0069] Whether the right ventricular free wall is thickened can be identified by the sign identification module, or 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 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 0.5 cm, the right ventricular free wall is thickened.

[0070] Whether the right heart contractile function is decreased can be identified by the sign identification module, or determined by the tricuspid annular plane systolic excursion TAPSE, right ventricular fractional area change RV-FAC, right ventricular free wall systolic rate and right ventricular septal systolic rate calculated by the first index calculation module. If the tricuspid annular plane systolic excursion TAPSE, right ventricular fractional area change RV-FAC, right ventricular free wall systolic rate and right ventricular septal systolic rate are all higher than the corresponding upper threshold value B2, it is determined that the right heart contractile function is not decreased; if one or more of the tricuspid annular plane systolic excursion TAPSE, right ventricular fractional area change RV-FAC, right ventricular free wall systolic rate and right ventricular septal systolic rate are lower than the corresponding lower threshold value B1, it is determined that the right heart contractile function is decreased. The upper threshold value B2 and the lower threshold value B1 are relatively set, and the upper threshold value B2 is greater than the lower threshold value B1.

[0071] Embodiment 6

[0072] As another preferred embodiment of the present application, referring to the description and drawings Figure 1 The present application comprises a right heart hemodynamics identification system, which comprises a right heart to left heart influence degree grading module, a right heart dysfunction potential cause classification module, a hemodynamics consequence analysis module, a pulmonary arterial hypertension identification module, a right heart hemodynamics classification module, and the right heart dysfunction identification system in the above embodiment 5.

[0073] The right heart to left heart influence degree grading module is used to obtain the grading result of the influence degree of the right heart to the left heart. The right heart dysfunction potential cause classification module is used to obtain the classification result of the potential cause of the right heart dysfunction. The hemodynamics consequence analysis module is used to determine the hemodynamics consequence, i.e. to determine the influence on the right heart output. The pulmonary arterial hypertension identification module is used to determine whether there is pulmonary arterial hypertension.

[0074] Due to the difficulty in evaluating the right heart, the characteristics of different right heart disorders determine the degree of hemodynamic impact and prognosis, and the characteristics of different right heart disorders suggest different causes of right heart disorders and different targeted treatments. For example, the D sign of the interventricular septum determines the degree of right heart pressure rise and the influence of the disorder degree on the left heart, which is the main cause of hemodynamic impact. The left heart output is the consequence, and by distinguishing between the two, the main cause of hemodynamic disorder in severe patients can be clearly found and targeted treatment can be performed. In the analysis of the underlying cause, volume overload / pressure overload also clearly directs different fluid treatments or targeted assessment and treatment of factors that increase the pressure of the right heart afterload (lungs / pulmonary circulation). The right heart systolic function helps clinicians determine whether to use cardiac drugs, and the right heart systole combined with the right heart pressure state determines the management of fluid (if the right heart pressure is high, cautious fluid treatment or even reverse fluid treatment is needed, and the use of cardiac drugs is considered; if the right heart pressure is not high, the right heart systole is poor, and fluid supplementation may be needed).

[0075] Therefore, in the present application, 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 underlying cause of right heart dysfunction, the hemodynamic consequences, whether there is pulmonary hypertension, and whether there is dysfunction of the right heart function.

[0076] Embodiment 7

[0077] As another preferred embodiment of the present application, 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.

[0078] The right heart influence on the left heart grading module, the right heart dysfunction underlying 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 recognition module. The hemodynamic consequence analysis module and the pulmonary hypertension identification module can share the second index calculation module.

[0079] The second image acquisition module is used to acquire ultrasonic images of the apical five-chamber view, the parasternal left ventricular short-axis view, and the pulmonary artery long-axis / right ventricular outflow tract view by a heart ultrasonic probe, and is also used to acquire Doppler blood flow spectrum graphs. The acquired ultrasonic images are transmitted to the second image processing and recognition module.

[0080] The second image processing and recognition module is configured to pre-process the received ultrasonic images, to obtain qualified ultrasonic images of each section, and to identify the left ventricular endocardium of the parasternal left ventricular short axis section, the interventricular septum endocardium of the parasternal left ventricular short axis section, the right ventricular endocardium of the parasternal left ventricular short axis section, the aortic valve root of the five-chamber heart, and the pulmonary artery root of the pulmonary artery long axis / right ventricular outflow tract section.

[0081] The second index calculation module is configured to calculate each second index according to the Doppler blood flow spectrum and the identified regions in the qualified ultrasonic images of each section. The second index includes a tricuspid regurgitation pressure difference TR-PG and a second index for judging the hemodynamic consequences.

[0082] Embodiment 8

[0083] As another preferred embodiment of the present application, this embodiment is a further detailed supplement and elaboration based on the above-mentioned embodiment 6. In this embodiment, the right heart influence on left heart degree 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 recognition module. The hemodynamic consequence analysis module and the pulmonary hypertension identification module are each separately provided with a second index calculation module.

[0084] Specifically, the right heart influence on left heart degree grading module can acquire ultrasonic images of the parasternal left ventricular short axis section according to the second image acquisition module, and transmit the ultrasonic images to the second image processing and recognition module of the right heart influence on left heart degree grading module, to finally identify the morphology and stage of the parasternal left ventricular short axis interventricular septum.

[0085] The right heart dysfunction potential cause classification module can acquire ultrasonic images of the parasternal left ventricular short axis section or the four-chamber heart section according to the second image acquisition module, and transmit the ultrasonic images to the second image processing and recognition module of the right heart dysfunction potential cause classification module, to identify the parasternal left ventricular short axis interventricular septum endocardium, the four-chamber heart right ventricular free wall endocardium, and the four-chamber heart interventricular septum endocardium.

[0086] The pulmonary hypertension identification module can acquire a Doppler blood flow spectrum according to the second image acquisition module, and the second index calculation module of the pulmonary hypertension identification module calculates a tricuspid regurgitation pressure difference TR-PG.

[0087] The hemodynamic consequence analysis module can collect the ultrasonic images of the apical five-chamber heart section and the pulmonary artery long axis / right ventricular outflow tract section and the Doppler blood flow spectrum according to the second image acquisition module, and transmit them to the second image processing and recognition module of the hemodynamic consequence analysis module to recognize the aortic valve root of the apical five-chamber heart and the pulmonary artery root of the pulmonary artery long axis / right ventricular outflow tract section; and finally, the second index calculation module of the hemodynamic consequence analysis module is used to calculate the second index for judging the hemodynamic consequence.

[0088] Embodiment 9

[0089] As another preferred embodiment of the present application, this embodiment is a further detailed supplement and elaboration on the basis of 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 further included.

[0090] The second image acquisition module can be integrated with the first image acquisition module, so that the integrated image acquisition module can collect the ultrasonic images of the trans-thoracic cardiac apical four-chamber heart section, the apical five-chamber heart section, the parasternal left ventricular short-axis section, the pulmonary artery long axis / right ventricular outflow tract section, and the subxiphoid four-chamber heart section, and collect the Doppler blood flow spectrum through the cardiac ultrasonic probe.

[0091] 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 endocardium and the specific parts required in real time: including the left and right ventricular endocardium, the left and right atrial endocardium, the right ventricular free wall endocardium, the interventricular septum endocardium, and the tricuspid valve right ventricular free wall annulus root in the four-chamber heart section; the left ventricular endocardium, the interventricular septum endocardium, and the right ventricular endocardium in the left ventricular short-axis section; the apical five-chamber heart aortic valve root; and the pulmonary artery root in the pulmonary artery long axis / right ventricular outflow tract section.

[0092] The second index calculation module can be integrated with the first index calculation module, so that the integrated index calculation module can calculate the indexes including: left ventricular endocardial area at diastole, right ventricular endocardial area at diastole, right ventricular free wall thickness, right atrial area, index for judging whether the right heart systolic function is decreased, tricuspid regurgitation pressure difference TR-PG, and index for judging the hemodynamic consequence.

[0093] Embodiment 10

[0094] As another preferred embodiment of the present application, this embodiment is a further detailed supplement and elaboration on the basis of any one of the above-mentioned embodiments 6~9.

[0095] In this embodiment, based on the right heart influence degree grading module, the influence degree of the right heart on the left heart can be graded according to the morphology and stage of the parasternal left ventricular short axis interventricular septum. The grading result of the influence degree of the right heart on the left heart includes normal, mild, moderate and severe. More specifically, if there is no D sign of the parasternal left ventricular short axis interventricular septum, the influence degree of the right heart on the left heart is normal; if there is shaking of the parasternal left ventricular short axis interventricular septum, the influence degree of the right heart on the left heart is mild; if there is diastolic D sign of the parasternal left ventricular short axis interventricular septum, the influence degree of the right heart on the left heart is moderate; and if there is double-period D sign of the parasternal left ventricular short axis interventricular septum, the influence degree of the right heart on the left heart is severe.

[0096] Since the larger the centrifugal index value is, the greater the right heart pressure is, and the greater the influence on the left heart is. If the influence degree of the right heart on the left heart cannot be graded according to the morphology and stage of the parasternal left ventricular short axis interventricular septum, the influence degree of the right heart on the left heart can be graded according to the centrifugal index calculated by the parasternal left ventricular short axis interventricular septum endometrium.

[0097] Embodiment 11

[0098] As another preferred embodiment of the present application, this embodiment is a further detailed supplement and elaboration of the right heart influence degree grading module based on the above-mentioned embodiment 10. When the diastolic D sign of the parasternal left ventricular short axis interventricular septum or the double-period D sign of the parasternal left ventricular short axis interventricular septum appears, the centrifugal index is calculated by the parasternal left ventricular short axis interventricular septum endometrium to further judge the influence degree of the right heart on the left heart. For example, according to the morphology and stage of the parasternal left ventricular short axis interventricular septum, it is judged that the influence degree of the right heart on the left heart is moderate, and according to the centrifugal index, the moderate is further graded, such as moderate degree 1, moderate degree 2 or moderate degree 3, etc. Through this refined grading, the effect of the later auxiliary decision is better.

[0099] Embodiment 12

[0100] As another preferred embodiment of the present application, the embodiment is a further detailed supplement and elaboration of the right heart dysfunction potential cause classification module based on any one of the above-mentioned embodiments 6 to 11. The right heart dysfunction potential cause includes right heart volume overload and right heart pressure overload. Due to the different pressure distributions in the right ventricle caused by volume overload or pressure overload, the wall motion in the systolic and diastolic movement presents different states and motion patterns, for example, there is a central concave area in the interventricular septum when the pressure overload (i.e. pulmonary hypertension) occurs. Therefore, the right heart dysfunction potential cause classification module completes the classification of the right heart dysfunction potential cause specifically as follows: a parasternal left ventricular short-axis interventricular septum motion trajectory curve is drawn according to the parasternal left ventricular short-axis interventricular septum endocardium, or a four-chamber right ventricular free wall and interventricular septum motion trajectory curve is drawn according to the four-chamber right ventricular free wall endocardium and the four-chamber interventricular septum endocardium. By the shape of the parasternal left ventricular short-axis interventricular septum motion trajectory curve or the four-chamber right ventricular free wall and interventricular septum motion trajectory curve, it is determined that the right heart dysfunction potential cause is right heart volume overload or right heart pressure overload (i.e. pulmonary hypertension).

[0101] Embodiment 13

[0102] As another preferred embodiment of the present application, the embodiment is a further detailed supplement and elaboration of the hemodynamic consequence analysis module based on any one of the above-mentioned embodiments 6 to 12. The hemodynamic consequence analysis module is used to determine the influence on the right heart output according to the indicators for determining the hemodynamic consequence. Among them, the indicators for determining the hemodynamic consequence include: aortic flow 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 flow velocity integral AV-VTI and the pulmonary artery velocity time integral PV-VTI can be calculated according to the Doppler blood flow spectrum. In combination with the apical five-chamber aortic valve root diameter d1 and the pulmonary artery long axis / right ventricular outflow tract section pulmonary artery root diameter d2, 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 .

[0103] Embodiment 14

[0104] As another preferred embodiment of the present application, the embodiment is a further detailed supplement and elaboration of the pulmonary hypertension identification module based on any one of the above-mentioned embodiments 6 to 13.

[0105] The pulmonary hypertension identification module compares the calculated tricuspid regurgitation pressure difference TR-PG with a corresponding threshold value, and if the tricuspid regurgitation pressure difference TR-PG is higher than the corresponding threshold value, it is determined that there is pulmonary hypertension. The tricuspid regurgitation pressure difference TR-PG can be calculated according to the Doppler blood flow spectrum. This calculation method is a conventional technical means in the art, and will not be described here.

[0106] If there is no tricuspid regurgitation pressure difference TR-PG, the left ventricular short-axis interventricular septum motion trajectory form can be used to determine whether there is a form indicating pulmonary hypertension, supplemented by the four-chamber heart right ventricular free wall and interventricular septum motion trajectory form. For example, the left ventricular short-axis interventricular septum will appear central concave performance in the case of pulmonary hypertension.

[0107] Embodiment 15

[0108] As another preferred embodiment of the present application, this embodiment is a further detailed supplement and elaboration of the right heart blood flow dynamics classification module based on any one of the above embodiments 6 to 14. The right heart blood flow dynamics phenotype classification specifically includes: acute right heart source type left ventricular output significantly decreased phenotype caused by pulmonary hypertension, chronic right heart dysfunction left ventricular output normal phenotype, and left ventricular output slightly decreased phenotype caused by right heart slightly increased volume overload, etc.

[0109] More specifically, if the tricuspid regurgitation pressure difference TR-PG is higher than the corresponding threshold value 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 value, it is an acute right heart source type left ventricular output significantly decreased phenotype caused by pulmonary hypertension.

[0110] If the tricuspid regurgitation pressure difference TR-PG is higher than the corresponding threshold value or the potential cause of right heart dysfunction is mainly pressure overload, and there is chronic 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 higher than the corresponding threshold value, it is a chronic right heart dysfunction left ventricular output normal phenotype.

[0111] If the potential cause of right heart dysfunction is mainly right heart volume overload, and 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 value, it is a left ventricular output slightly decreased phenotype caused by right heart slightly increased volume overload, etc.

[0112] Embodiment 16

[0113] As another preferred embodiment of the present application, the embodiment is further detailed and supplemented to the right heart hemodynamic identification system based on any one of the above-mentioned embodiments 6 to 15. The right heart hemodynamic identification system further comprises a warning module, which gives a preliminary warning if there is acute right heart dysfunction, and gives a high warning if there is acute right heart dysfunction, 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 values.

[0114] Embodiment 17

[0115] As another preferred embodiment of the present application, the present application comprises an auxiliary decision-making system based on the classification results of the right heart hemodynamic phenotype of the right heart hemodynamic identification system in the above-mentioned embodiment 15 to make auxiliary decision-making. More specifically, if the right heart hemodynamic phenotype is the acute right heart caused by pulmonary hypertension, which leads to a significant decrease in left ventricular output, the treatment is mainly to screen the causes of increased right heart afterload, evaluate the lungs and pulmonary vessels, and relieve obstruction; if the right heart hemodynamic phenotype is the chronic right heart dysfunction with normal left heart output, the treatment is mainly to carefully manage fluid output, closely monitor the dynamic trend, and give a warning; if the right heart hemodynamic phenotype is the mild decrease in left heart output caused by mild enlargement of right heart with volume overload, the treatment is mainly to dehydrate and diurese.

[0116] In summary, various corresponding transformation schemes made by those skilled in the art without creative mental effort according to the technical solutions and technical concepts of the present application after reading the present application file all belong to the scope of protection of the present application.

Claims

1. A right heart hemodynamic identification system, characterized by: The right heart to left heart influence degree grading module, the right heart dysfunction potential cause classification module, the hemodynamic consequence analysis module, the pulmonary hypertension identification module, the right heart hemodynamics classification module, and the right heart dysfunction identification system; The right heart to left heart influence degree grading module is used to obtain a grading result of the influence degree of the right heart on the left heart; the right heart dysfunction potential cause classification module is used to obtain a classification result of the potential cause of the right heart dysfunction; the hemodynamic consequence analysis module is used to judge the hemodynamic consequence; and the pulmonary hypertension identification module is used to judge whether there is pulmonary hypertension. The right heart dysfunction identification system includes a first image acquisition module, a first image processing and identification module, a first index calculation module or / and a sign identification module, and a right heart dysfunction identification classification module; the first image acquisition module is used to acquire ultrasonic images of different sections of the heart by a heart ultrasonic probe and transmit the images to the first image processing and identification module; the first image processing and identification module is used to pre-process the received ultrasonic images to obtain qualified ultrasonic images of each section, 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 interventricular septum endocardium, and the tricuspid valve right ventricular free wall annulus root in the qualified ultrasonic images of each section; the sign identification module is used to identify each sign according to the identified regions in the qualified ultrasonic images of each section; the first index calculation module is used to calculate first indexes corresponding to each sign according to the identified regions in the qualified ultrasonic images 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 systolic function is decreased; the right heart dysfunction identification classification module is used to identify each sign according to the signs identified by the sign identification module or / and the first indexes calculated by the first index calculation module, identify whether there is a right heart dysfunction, and classify the acuteness of the dysfunction; The right heart hemodynamics classification module is used to classify the right heart hemodynamics phenotype according to the grading result of the influence degree of the right heart on the left heart, the classification result of the potential cause of the right heart dysfunction, the hemodynamic consequence, whether there is pulmonary hypertension, whether there is a right heart dysfunction, and the acuteness of the dysfunction, including: an acute right heart source type leading to a significant decrease in left ventricular output, a chronic right heart dysfunction type with normal left heart output, and a volume overload type with mild right heart enlargement leading to mild decrease in left heart output.

2. The right heart hemodynamics identification system of claim 1, wherein: The different sections of the heart include a trans-thoracic apical four-chamber heart section and / or a sub-xiphoid four-chamber heart section.

3. The right heart hemodynamics identification system of claim 1, wherein: The first index corresponding to whether the right ventricular free wall is thickened includes the right ventricular free wall thickness; the first index corresponding to whether the right atrium is enlarged includes the right atrial area; and the first index 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 hemodynamics identification system of claim 3, wherein: The specific calculation method of each first index comprises: calculating left ventricular end-diastolic intima area according to left ventricular end-diastolic intima of four-chamber heart section, and calculating right ventricular end-diastolic intima area according to right ventricular end-diastolic intima of four-chamber heart section; calculating right ventricular free wall thickness according to right ventricular free wall intima of four-chamber heart section; and calculating right atrial area according to right atrial intima of four-chamber heart section.

5. The right heart hemodynamics identification system of claim 1, wherein: The first index corresponding to whether the right heart systolic function is decreased comprises tricuspid annulus root displacement TAPSE, right ventricular area change rate RV-FAC, right ventricular free wall systolic rate and right ventricular septal systolic rate.

6. The right heart hemodynamics identification system of claim 5, wherein: The specific calculation method of the first index corresponding to whether the right heart systolic function is decreased comprises: calculating tricuspid annulus root displacement TAPSE according to tricuspid right ventricular free wall annulus root; calculating right ventricular area change rate RV-FAC according to right ventricular intima of four-chamber heart section; calculating right ventricular free wall systolic rate according to right ventricular free wall intima; and calculating right ventricular septal systolic rate according to four-chamber ventricular septal intima.

7. The right heart hemodynamics identification system of claim 5, wherein: If the tricuspid annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall systolic rate and the right ventricular septal systolic rate are all higher than the corresponding upper threshold, it is judged that the right heart systolic function is not decreased; if one or more of the tricuspid annulus root displacement TAPSE, the right ventricular area change rate RV-FAC, the right ventricular free wall systolic rate and the right ventricular septal systolic rate are lower than the corresponding lower threshold, it is judged that the right heart systolic function is decreased.

8. The right heart hemodynamics identification system of claim 1, wherein: The right heart function is identified whether there is an obstacle, and the obstacle is classified into acute and chronic, specifically: if the right ventricle is not enlarged, and the right atrium is not enlarged, and the right ventricular free wall is not thickened, and the right heart systolic function is not decreased, it is identified that the right heart function has no obvious abnormalities; 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. The right heart hemodynamics identification system of claim 1, wherein: It also comprises a second image acquisition module, a second image processing and identification module and a second index calculation module; the second image acquisition module is used for acquiring ultrasonic images of different sections of the heart by a heart ultrasonic probe, and transmitting them to the second image processing and identification module, and is also used for acquiring Doppler blood flow spectrum; the second image processing and identification module is used for pre-processing the received ultrasonic images to obtain qualified ultrasonic images of each section, and identifying left ventricular end-diastolic intima of parasternal left ventricular short axis section, intramembranous septum of parasternal left ventricular short axis section, right ventricular end-diastolic intima of parasternal left ventricular short axis section, tricuspid annulus root of apical five-chamber heart section and pulmonary artery root of pulmonary artery long axis / right ventricular outflow tract section; the second index calculation module is used for calculating each second index according to the Doppler blood flow spectrum and the identified regions in the qualified ultrasonic images of each section; the second index comprises tricuspid regurgitation pressure difference TR-PG and a second index for judging hemodynamic consequences.

10. The right heart hemodynamics identification system of claim 9, wherein: Different sections of heart include apical five-chamber view, parasternal short-axis view of left ventricle and long-axis view of pulmonary artery / right ventricular outflow tract.

11. The right heart hemodynamics identification system of claim 9, wherein: The second index for judging hemodynamic consequences includes 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.

12. The right heart hemodynamics identification system of claim 9, wherein: The right heart impact on left heart grading module is used to obtain a grading result of the right heart impact on the left heart, and the grading result specifically refers to grading the right heart impact on the left heart according to the morphology and stage of the interventricular septum of the parasternal short-axis view of the left ventricle or / and the centrifugal index calculated according to the endometrium of the parasternal short-axis view of the left ventricle.

13. The right heart hemodynamics identification system of claim 12, wherein: The grading result of the right heart impact on the left heart includes normal, mild, moderate and severe.

14. The right heart hemodynamics identification system of claim 13, wherein: If there is no D sign of the interventricular septum of the parasternal short-axis view of the left ventricle, the right heart impact on the left heart is normal. If there is flutter of the interventricular septum of the parasternal short-axis view of the left ventricle, the right heart impact on the left heart is mild; if there is diastolic D sign of the interventricular septum of the parasternal short-axis view of the left ventricle, the right heart impact on the left heart is moderate; and if there is double-phase D sign of the interventricular septum of the parasternal short-axis view of the left ventricle, the right heart impact on the left heart is severe.

15. The right heart hemodynamics identification system of claim 14, wherein: When there is diastolic D sign of the interventricular septum of the parasternal short-axis view of the left ventricle or double-phase D sign of the interventricular septum of the parasternal short-axis view of the left ventricle, the centrifugal index is calculated according to the endometrium of the parasternal short-axis view of the left ventricle to further judge the right heart impact on the left heart.

16. The right heart hemodynamics identification system of claim 9, wherein: The right heart dysfunction potential cause classification module is used to complete classification of the potential cause of right heart dysfunction, and the classification specifically refers to drawing a parasternal short-axis interventricular septum motion trajectory curve according to the endometrium of the parasternal short-axis view of the left ventricle, or drawing a four-chamber right ventricular free wall and interventricular septum motion trajectory curve according to the endometrium of the four-chamber right ventricular free wall and interventricular septum; and the potential cause of right heart dysfunction is determined to be mainly right heart volume overload or mainly right heart pressure overload according to the morphology of the parasternal short-axis interventricular septum motion trajectory curve or the four-chamber right ventricular free wall and interventricular septum motion trajectory curve.

17. The right heart hemodynamic identification system according to claim 11, wherein: if the tricuspid regurgitation pressure gradient TR-PG is higher than a corresponding threshold value or the potential cause of right heart dysfunction is mainly pressure overload, and there is acute right heart dysfunction, and the right heart impact on the left heart is moderate or severe, and the aortic velocity integral AV-VTI and the aortic valve stroke volume AV-SV are both lower than corresponding threshold values, it is an acute right heart caused left heart output significantly decreased phenotype caused by main pulmonary hypertension; if the tricuspid regurgitation pressure gradient TR-PG is higher than a corresponding threshold value or the potential cause of right heart dysfunction is mainly pressure overload, and there is chronic right heart dysfunction, and the right heart impact on the left heart is moderate or severe, and the aortic velocity integral AV-VTI and the aortic valve stroke volume AV-SV are higher than corresponding threshold values, it is a chronic right heart dysfunction left heart output normal phenotype; If the underlying cause of the right heart dysfunction is mainly right heart volume overload, and the right ventricle is enlarged, and one or both of the aortic flow integral AV-VTI and the aortic valve stroke volume AV-SV is lower than the corresponding threshold value, it is the left heart output mild decline phenotype caused by mild enlargement of right heart with volume overload as the main cause.

18. The right heart hemodynamics identification system of claim 17, wherein: The early warning module is further included, and a preliminary warning is given if there is acute right heart dysfunction; if there is acute right heart dysfunction, and the degree of influence of the right heart on the left heart is moderate or severe, and both the aortic flow integral AV-VTI and the aortic valve stroke volume AV-SV are lower than the corresponding threshold value, a high warning is given.

19. A decision support system, characterized by: The right heart hemodynamic identification system based on claim 1 makes auxiliary decisions on the classification results of the right heart hemodynamic phenotype.

20. A decision support system according to claim 19, characterised in that: The auxiliary decision specifically refers to: if the right heart hemodynamic phenotype is the acute right heart caused left ventricular output significant decline phenotype mainly caused by pulmonary hypertension, it is suggested to mainly treat the causes of right heart afterload increase, evaluate the lungs and pulmonary vessels, and remove the obstruction; if the right heart hemodynamic phenotype is the left heart output normal phenotype of chronic right heart dysfunction, it is suggested to mainly treat the liquid output with cautious management, closely monitor the dynamic change trend, and give early warning; If the right heart hemodynamic phenotype is the left heart output mild decline phenotype caused by mild enlargement of right heart with volume overload as the main cause, it is suggested to mainly treat the treatment with dehydration and diuresis.

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