Predicting cardiac disease from interactions of simultaneously-acquired hemodynamic and cardiac signals

被引:13
作者
Fathieh, Farhad [1 ,4 ]
Paak, Mehdi [1 ,4 ]
Khosousi, Ali [1 ]
Burton, Tim [1 ]
Sanders, William E. [2 ]
Doomra, Abhinav [1 ]
Lange, Emmanuel [1 ]
Khedraki, Rola [3 ]
Bhavnani, Sanjeev [3 ]
Ramchandani, Shyam [1 ]
机构
[1] CorVista Hlth, 160 Bloor St East,Suite 910, Toronto, ON, Canada
[2] CorVista Hlth Inc, 401 Harrison Oaks Blvd,Suite 100, Cary, NC USA
[3] Scripps Clin, Healthcare Innovat Lab, Div Cardiovasc Med, San Diego, CA USA
[4] Dba CorVista Hlth, Life Inc, Toronto, ON, Canada
关键词
photoplethysmography (PPG); Three-dimensional orthogonal voltage gradient (OVG); Nonlinear dynamics; Machine learning: Coronary artery disease; Left ventricular end-diastolic pressure; END-DIASTOLIC PRESSURE; VENTRICULAR FILLING PRESSURES; HEART-FAILURE; DOPPLER-ECHOCARDIOGRAPHY; ARTIFICIAL-INTELLIGENCE; EJECTION FRACTION; RISK PROFILE; DIAGNOSIS; PHOTOPLETHYSMOGRAPHY; DIFFERENCE;
D O I
10.1016/j.cmpb.2021.105970
中图分类号
TP39 [计算机的应用];
学科分类号
081203 ; 0835 ;
摘要
Background and Objective: Coronary artery disease (CAD) and heart failure are the most common cardiovascular diseases. Non-invasive diagnostic testing for CAD requires radiation, heart rate acceleration, and imaging infrastructure. Early detection of left ventricular dysfunction is critical in heart failure management, the best measure of which is an elevated left ventricular end-diastolic pressure (LVEDP) that can only be measured using invasive cardiac catheterization. There exists a need for non-invasive, safe, and fast diagnostic testing for CAD and elevated LVEDP. This research employs nonlinear dynamics to assess for significant CAD and elevated LVEDP using non-invasively acquired photoplethysmographic (PPG) and three-dimensional orthogonal voltage gradient (OVG) signals. PPG (variations of the blood volume perfusing the tissue) and OVG (mechano-electrical activity of the heart) signals represent the dynamics of the cardiovascular system. Methods: PPG and OVG were simultaneously acquired from two cohorts, (i) symptomatic subjects that underwent invasive cardiac catheterization, the gold standard test (408 CAD positive with stenosis >= 70% and 186 with LVEDP >= 20 mmHg) and (ii) asymptomatic healthy controls (676). A set of Poincare-based synchrony features were developed to characterize the interactions between the OVG and PPG signals. The extracted features were employed to train machine learning models for CAD and LVEDP. Five-fold cross-validation was used and the best model was selected based on the average area under the receiver operating characteristic curve (AUC) across 100 runs, then assessed using a hold-out test set. Results: The Elastic Net model developed on the synchrony features can effectively classify CAD positive subjects from healthy controls with an average validation AUC=0.90 +/- 0.03 and an AUC=0.89 on the test set. The developed model for LVEDP can discriminate subjects with elevated LVEDP from healthy controls with an average validation AUC=0.89 +/- 0.03 and an AUC=0.89 on the test set. The feature contributions results showed that the selection of a proper registration point for Poincareanalysis is essential for the development of predictive models for different disease targets. Conclusions: Nonlinear features from simultaneously-acquired signals used as inputs to machine learning can assess CAD and LVEDP safely and accurately with an easy-to-use, portable device, utilized at the point-of-care without radiation, contrast, or patient preparation. (C) 2021 The Authors. Published by Elsevier B.V.
引用
收藏
页数:13
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