scholarly journals Artificial intelligence in echocardiography diagnostics – detection of takotsubo syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Di Vece ◽  
F Laumer ◽  
M Schwyzer ◽  
R Burkholz ◽  
L Corinzia ◽  
...  

Abstract Background Machine learning allows classifying diseases based only on raw echocardiographic imaging data and is therefore a landmark in the development of computer-assisted decision support systems in echocardiography. Purpose The present study sought to determine the value of deep (machine) learning systems for automatic discrimination of takotsubo syndrome and acute myocardial infarction. Methods Apical 2- and 4-chamber echocardiographic views of 110 patients with takotsubo syndrome and 110 patients with acute myocardial infarction were used in the development, training and validation of a deep learning approach, i.e. a convolutional autoencoder (CAE) for feature extraction followed by classical machine learning models for classification of the diseases. Results The deep learning model achieved an area under the receiver operating curve (AUC) of 0.801 with an overall accuracy of 74.5% for 5-fold cross validation evaluated on a clinically relevant dataset. In comparison, experienced cardiologists achieved AUCs in the range 0.678–0.740 and an average accuracy of 64.5% on the same dataset. Conclusions A real-time system for fully automated interpretation of echocardiographic videos was established and trained to differentiate takotsubo syndrome from acute myocardial infarction. The framework provides insight into the algorithms' decision process for physicians and yields new and valuable information on the manifestation of disease patterns in echocardiographic data. While our system was superior to cardiologists in echocardiography-based disease classification, further studies should be conducted in a larger patient population to prove its clinical application. Funding Acknowledgement Type of funding source: None

Author(s):  
Dhilsath Fathima.M ◽  
S. Justin Samuel ◽  
R. Hari Haran

Aim: This proposed work is used to develop an improved and robust machine learning model for predicting Myocardial Infarction (MI) could have substantial clinical impact. Objectives: This paper explains how to build machine learning based computer-aided analysis system for an early and accurate prediction of Myocardial Infarction (MI) which utilizes framingham heart study dataset for validation and evaluation. This proposed computer-aided analysis model will support medical professionals to predict myocardial infarction proficiently. Methods: The proposed model utilize the mean imputation to remove the missing values from the data set, then applied principal component analysis to extract the optimal features from the data set to enhance the performance of the classifiers. After PCA, the reduced features are partitioned into training dataset and testing dataset where 70% of the training dataset are given as an input to the four well-liked classifiers as support vector machine, k-nearest neighbor, logistic regression and decision tree to train the classifiers and 30% of test dataset is used to evaluate an output of machine learning model using performance metrics as confusion matrix, classifier accuracy, precision, sensitivity, F1-score, AUC-ROC curve. Results: Output of the classifiers are evaluated using performance measures and we observed that logistic regression provides high accuracy than K-NN, SVM, decision tree classifiers and PCA performs sound as a good feature extraction method to enhance the performance of proposed model. From these analyses, we conclude that logistic regression having good mean accuracy level and standard deviation accuracy compared with the other three algorithms. AUC-ROC curve of the proposed classifiers is analyzed from the output figure.4, figure.5 that logistic regression exhibits good AUC-ROC score, i.e. around 70% compared to k-NN and decision tree algorithm. Conclusion: From the result analysis, we infer that this proposed machine learning model will act as an optimal decision making system to predict the acute myocardial infarction at an early stage than an existing machine learning based prediction models and it is capable to predict the presence of an acute myocardial Infarction with human using the heart disease risk factors, in order to decide when to start lifestyle modification and medical treatment to prevent the heart disease.


2021 ◽  
Author(s):  
Aditya Nagori ◽  
Anushtha Kalia ◽  
Arjun Sharma ◽  
Pradeep Singh ◽  
Harsh Bandhey ◽  
...  

Shock is a major killer in the ICU and machine learning based early predictions can potentially save lives. Generalization across age and geographical context is an unaddressed challenge. In this retrospective observational study, we built real-time shock prediction models generalized across age groups and continents. More than 1.5 million patient-hours of novel data from a pediatric ICU in New Delhi and 5 million patient-hours from the adult ICU MIMIC database were used to build models. We achieved model generalization through a novel fractal deep-learning approach and predicted shock up to 12 hours in advance. Our deep learning models showed a receiver operating curve (AUROC) drop from 78% (95%CI, 73-83) on MIMIC data to 66% (95%CI, 54-78) on New Delhi data, outperforming standard machine learning by nearly a 10% gap. Therefore, better representations and deep learning can partly address the generalizability-gap of ICU prediction models trained across geographies. Our data and algorithms are publicly available as a pre-configured docker environment at https://github.com/SAFE-ICU/ShoQPred.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Masato Shimizu ◽  
shummo cho ◽  
Yoshiki Misu ◽  
Mari Ohmori ◽  
Ryo Tateishi ◽  
...  

Introduction: Takotsubo syndrome (TTS) and acute anterior myocardial infarction (ant-AMI) show very similar 12-lead electrocardiography (ECG) featured at onset, and it is often difficult to distinguish them without cardiac catheterization. The difference of ECG between them was studied, but the diagnostic performance of machine learning (deep learning) for them had not been investigated. Hypothesis: Deep learning on 12-leads ECG has high diagnostic performance to diagnose TTS and ant-AMI at onset. Methods: Consecutive 50 patients of TTS were one-to-one matched to ant-AMI randomly by their age and gender, and total 100 patients were enrolled. No sinus rhythm patients were excluded. All ECGs were divided into each 12-lead, and 5 heart beats from one lead were extracted. For each lead, 250 ECG waves of TTS/AMI were sampled as 24bit bitmap image, and prediction model construction by convolutional neural network (CNN: transfer learning, using VGG16 architecture) underwent to distinguish the two diseases in each lead. Next, gradient weighted class activation color mapping (GradCam) was performed to detect the degree and position of convolutional importance in the leads. Results: Lead aVR (mean accuracy 0.748), I (0.733), and V1 (0.678) were the top 3 leads with high accuracy. In aVR lead, GradCam showed strong convolution of negative T wave in TTS, and sharp R wave in ant-AMI. In I lead, it spotlighted several parts of ECG wave in ant-AMI. However in TTS, whole shape of the wave, P wave onset, and negative T were invertedly convoluted in TTS. Conclusions: Deep learning was a powerful tool to distinguish TTS and ant-AMI at onset, and GradCam method gave us new insight of the difference on ECG between the two diseases.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Hoogeveen ◽  
J P Belo Pereira ◽  
V Zampoleri ◽  
M J Bom ◽  
W Koenig ◽  
...  

Abstract Background Currently used models to predict cardiovascular event risk have limited value. It has been shown repetitively that the addition of single biomarkers has modest impact. Recently we observed that a model consisting of a larger array of plasma proteins performed very well in predicting the presence of vulnerable plaques in primary prevention patients. However, the validation of this protein panel in predicting cardiovascular outcomes remains to be established. Purpose This study investigated the ability of a 384 preselected protein biomarkers to predict acute myocardial infarction, using state-of-the-art machine learning techniques. Secondly, we compared the performance of this multi-protein risk model to traditional risk engines. Methods We selected 822 subjects from the EPIC-Norfolk prospective cohort study, of whom 411 suffered a myocardial infarction during follow-up (median 15 years) compared to 411 controls who remained event-free (median follow-up 20 years). The 384 proteins were measured using proximity extension assay technology. Machine learning algorithms (random forests) were used for the prediction of acute myocardial infarction (ICD code I21–22). Performance of the model was tested against and on top of traditional risk factors for cardiovascular disease (refit Framingham). All performance measurements were averaged over several stability selection routines. Results Prediction of myocardial infarction using a machine-learning model consisting of 50 plasma proteins resulted in a ROC AUC of 0.74±0.14, in comparison to 0.69±0.17 using traditional risk factors (refit Framingham. Combining the proteins and refit Framingham resulted in a ROC AUC of 0.74±0.15. Focussing on events occurring within 3 years after baseline blood withdrawal, the ROC AUC increased to 0.80±0.09 using 50 plasma proteins, as opposed to 0.67±0.22 using refit Framingham (figure). Combining the protein model with refit Framingham resulted in a ROC AUC of 0.82±0.11 for these events. Diagnostic performance events <3yrs Conclusion High-throughput proteomics outperforms traditional risk factors in prediction of acute myocardial infarction. Prediction of myocardial infarction occurring within 3 years after inclusion showed highest performance. Availability of affordable proteomic approaches and developed machine learning pave the path for clinical implementation of these models in cardiovascular risk prediction. Acknowledgement/Funding This study was funded by an ERA-CVD grant (JTC2017) and EU Horizon 2020 grant (REPROGRAM, 667837)


2020 ◽  
Vol 30 (06) ◽  
pp. 2050032
Author(s):  
Wei Feng ◽  
Nicholas Van Halm-Lutterodt ◽  
Hao Tang ◽  
Andrew Mecum ◽  
Mohamed Kamal Mesregah ◽  
...  

In the context of neuro-pathological disorders, neuroimaging has been widely accepted as a clinical tool for diagnosing patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). The advanced deep learning method, a novel brain imaging technique, was applied in this study to evaluate its contribution to improving the diagnostic accuracy of AD. Three-dimensional convolutional neural networks (3D-CNNs) were applied with magnetic resonance imaging (MRI) to execute binary and ternary disease classification models. The dataset from the Alzheimer’s disease neuroimaging initiative (ADNI) was used to compare the deep learning performances across 3D-CNN, 3D-CNN-support vector machine (SVM) and two-dimensional (2D)-CNN models. The outcomes of accuracy with ternary classification for 2D-CNN, 3D-CNN and 3D-CNN-SVM were [Formula: see text]%, [Formula: see text]% and [Formula: see text]% respectively. The 3D-CNN-SVM yielded a ternary classification accuracy of 93.71%, 96.82% and 96.73% for NC, MCI and AD diagnoses, respectively. Furthermore, 3D-CNN-SVM showed the best performance for binary classification. Our study indicated that ‘NC versus MCI’ showed accuracy, sensitivity and specificity of 98.90%, 98.90% and 98.80%; ‘NC versus AD’ showed accuracy, sensitivity and specificity of 99.10%, 99.80% and 98.40%; and ‘MCI versus AD’ showed accuracy, sensitivity and specificity of 89.40%, 86.70% and 84.00%, respectively. This study clearly demonstrates that 3D-CNN-SVM yields better performance with MRI compared to currently utilized deep learning methods. In addition, 3D-CNN-SVM proved to be efficient without having to manually perform any prior feature extraction and is totally independent of the variability of imaging protocols and scanners. This suggests that it can potentially be exploited by untrained operators and extended to virtual patient imaging data. Furthermore, owing to the safety, noninvasiveness and nonirradiative properties of the MRI modality, 3D-CNN-SMV may serve as an effective screening option for AD in the general population. This study holds value in distinguishing AD and MCI subjects from normal controls and to improve value-based care of patients in clinical practice.


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