Analysis of nonstandardized stress echocardiography sequences using multiview dimensionality reduction

Alternative stress echocardiography protocols such as handgrip exercise are potentially more favorable towards large-scale screening scenarios than those currently adopted in clinical practice. However, these are still underexplored because the maximal exercise levels are not easily quantified and regulated, requiring the analysis of the complete data sequences (thousands of images), which represents a challenging task for the clinician. We propose a framework for the analysis of these complex datasets, and illustrate it on a handgrip exercise dataset including complete acquisitions of 10 healthy controls and 5 ANT1 mutation patients (1377 cardiac cycles). The framework is based on an unsupervised formulation of multiple kernel learning, which is used to integrate information coming from myocardial velocity traces and heart rate to obtain a lower-dimensional representation of the data. Such simplified representation is then explored to discriminate groups of response and understand the underlying pathophysiological mechanisms. The analysis pipeline involves the reconstruction of population-specific signatures using multiscale kernel regression, and the clustering of subjects based on the trajectories defined by their projected sequences. The results confirm that the proposed framework is able to detect distinctive clusters of response and to provide insight regarding the underlying pathophysiology.