Predicting Heart Failure. Группа авторов

abdominal region of HF patients who go into a supine position enters the circulation. As a result, the kidneys detect excess volume and this increases urination. HF can be suspected if blood sugar is normal but there is frequent urination at night.

When at least one of these symptoms is noticed, often by the person themself, the control phase should start and the doctor should be consulted for diagnosis without delay. Even if going to the doctor does not solve the HF, it will contribute to one’s survival time and quality of life [2].

      1.2.4 HF Treatment

      Treatment in HF generally gives effective results, the purpose being a decrease in sudden death and an increase in survival time. Within the scope of treatment are acting to support a healthy life, medication use, medical support, and surgical interventions.

      In drug treatment, the patient is generally supported with more than one drug supplement. Medicines are used to strengthen the heart muscle, lower blood pressure, and remove the edema accumulated in the body. Some medicines used in the treatment of HF show blood thinning and cholesterol lowering effects. Many drugs are difficult for the patient, but their use can produce the desired effect.

      Surgical methods and medical support devices are other method used in treatment. Surgical methods and medical support aim to eliminate the irregularities that occur in the heart. One of the surgical methods is coronary bypass and another is heart valve replacement surgery. The most known and preferred method in the treatment of HF is undoubtedly heart surgery. Deciding this is itself an important issue. If the heart has become unable to perform its duties, and if medication or a stent are far from being a solution, a heart surgery decision should be made with a physician's recommendation.

      The use of pacemakers can also be considered within the scope of surgical methods. The function of pacemakers is to support the heart and, with a solution similar to a pacemaker, the disturbed rhythm of the heart is understood and shock is applied to the heart to eliminate the rhythm disturbance. In addition, placing a heart pump in the chest cavity to support the weakened heart is a method of treatment. One of the most effective and definitive solutions within surgical methods is heart transplantation. The broken heart is removed and a healthy heart is transplanted.

      One of the techniques that reduce the risk of heart attack and thus helps treatment is blood thinning. Thinning the blood is a known technique for preventing blood clotting, a significant problem that causes major diseases such as stroke, heart attack, and kidney failure. Pills, subcutaneous injections, or tubes placed in a vein are used to thin the blood. The pill is warfarin; the other methods use heparin.

      1.3 Invasive and Non-Invasive Procedures

A detailed clinical examination and patient history are important in diagnosing HF. In a detailed examination, symptoms of high blood pressure, high cholesterol, and high sugar levels should also be examined. In the diagnosis of HF, it should be considered whether the patient has had one of the diseases in the HF class previously. Physical examination is also one of the useful applications in terms of diagnosis, as it can reveal abnormalities in the patient that disrupt the balance of the body.

      There are numerous invasive, non-invasive, machine learning, and artificial intelligence based methods for diagnosing HF. While invasive methods roughly refer to the types of studies that can be seen as subcutaneous interventions, non-invasive methods refer to procedures performed outside the body, for example measuring blood pressure.

      1.3.1 What are Invasive and Non-Invasive Procedures?

      The invasive procedure – also called invasion – involves opening veins that are usually closed, stenting, needle procedures, and the like. Invasive procedures are generally performed by applying a physical effect to the body. For example, operations that cause an incision in the body, such as open surgery, are this type.

      Apart from invasive procedures, there are also non-invasive and minimally invasive methods. As a medical term, the invasive procedure is used for situations requiring surgical intervention, while non-invasive procedure is the name given to situations that do not require surgical procedures and do not need any intervention such as cutting or piercing the body. Measurement of a patient’s blood pressure and temperature are just two examples of the non-invasive method.

      Minimally invasive procedure refers to invasive studies performed in a very narrow area, in a very short time, and with little effect. For example, endoscopic interventions are known as minimally invasive methods and while taking blood from a vein for analysis is invasive, taking blood from a small incision in the tip of the finger is known to be minimally invasive.

      1.3.2 Diagnosis by Invasive Procedures

There are many invasive procedures in use, including surgical interventions. Tens of millions of invasive procedures are performed on patients worldwide almost every year [3].

One of the invasive tests for heart conditions is blood tests. Within the scope of blood tests, cardiac enzymes, C-reactive protein (CRP), fibrinogen, homocysteine, lipoproteins, triglycerides, brain natriuretic peptide (BNP), and prothrombin values are checked. Blood tests can confirm whether a heart attack has occurred, the extent of damage can be predicted, future risk can be found, and general information on blood clotting can be obtained [4].

      One of the tests that should be considered within the scope of blood tests is the troponin test, which is a method that can determine the risk of heart attack in healthy individuals. What is tested is the amount of troponin protein that is released when the heart muscle is damaged. Based on this measurement, the cases likely to have a heart attack in the coming years can be predicted.

Another invasive technique is known as heart catheterization. The inside of the heart and blood vessels are imaged using special x-rays called angiograms. A thin hollow tube, a catheter, is guided through a blood vessel in the arm, groin, or neck toward the heart. Dye is injected into the blood vessels through the catheter, thus enhancing the image quality of the x-ray. This process takes 2–3 hours on average and, through angiography, can lead to an understanding of what caused the chest pain – angiography can reveal both the obstruction in the vessels and the problem in the heart valves and, in addition, can measure the blood pressure and oxygen content within the heart [4].

      Since angiography has some limitations, non-invasive methods such as smart calculation algorithms are also frequently used and better results can sometimes be obtained.

      1.3.3 Diagnosis by Non-Invasive Procedures

      Pressure examination, hammer examination, ultrasonography are some common examples of non-invasive methods, and there are many non-invasive methods used in HF. Each method will be briefly mentioned in this section.

Electrocardiography is one of the non-invasive methods in HF. It monitors heart rhythm changes by recording the heart's electrical activity and, thus, determines whether a heart attack has occurred from abnormalities in rhythm. Electrocardiography and blood tests are the most common methods used in HF diagnosis and the aim of electrocardiography is to determine the complex factors underlying HF [5].

      Sometimes, the heart’s activity is recorded throughout the day, not just for a short time. This process is known as Holter monitoring. The method aims to determine how the heart responds during daily activities and the average heart rhythm. Holter monitoring not only detects abnormalities in the heart, but can also help doctors treat them.

Chest x-ray also provides a non-invasive method for diagnosing heart diseases, by taking a picture of the heart, lungs, and rib cage. With the radiological imaging performed, it can be seen if the heart is enlarged after a heart attack or fluid accumulation in the lungs. Systolic and diastolic dysfunction of the heart can be discovered through electrocardiography and chest x-ray [6].

Echocardiography has been used for many years to characterize HF [7]. It uses high frequency sound waves (ultrasound) to produce images of heart size, movement, and