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A Novel Continuous Left Ventricular Diastolic Function Score Using Machine Learning
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AI
DOI：10.1016/j.echo.2022.06.005.png)
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Abstract
En 中文
Background: Unlike left ventricular (LV) ejection fraction, which provides a precise, reliable, and prognostically valuable measure of systolic function, there is no single analogous measure of LV diastolic function.Objectives: We aimed to develop a continuous score to grade LV diastolic function using machine learning modeling of echocardiographic data.Methods: Consecutive echo studies performed at a tertiary-care center between February 1, 2010, and March 31, 2016, were assessed, excluding studies containing features that would interfere with diastolic function assessment as well as studies in which 1 or more parameters within the contemporary diastolic function assessment algorithm were not reported. Diastolic function was graded based on 2016 American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guidelines, excluding indeterminate studies. Machine learning models were trained (support vector machine [SVM], decision tree [DT], XGBoost [XGB], and dense neural network [DNN]) to classify studies within the training set by diastolic dysfunction severity, blinded to the ASE/EACVI classification. The DNN model was retrained to generate a regression model (R-DNN) to predict a continuous LV diastolic function score.Results: A total of 28,986 studies were included; 23,188 studies were used to train the models, and 5,798 studies were used for validation. The models were able to reclassify studies with high agreement to the ASE/EACVI al-gorithm (SVM, 83%; DT, 100%; XGB, 100%; DNN, 98%). The continuous diastolic function score corresponded well with ASE/EACVI guidelines, with scores of 1.00 +/- 0.01 for studies with normal function and 0.74 +/- 0.05, 0.51 +/- 0.06, and 0.27 +/- 0.11 for mild, moderate, and severe diastolic dysfunction, respectively (mean +/- 1 SD). A score of <0.91 predicted abnormal diastolic function (area under the receiver operator curve = 0.99), while a score of <0.65 predicted elevated filling pressure (area under the receiver operator curve = 0.99).Conclusions: Machine learning can assimilate echocardiographic data and generate an automated continuous diastolic function score that corresponds well with current diastolic function grading recommendations. (J Am Soc Echocardiogr 2022;35:1247-55.)
Keywords:
Diastolic function
Echocardiography
Artificial intelligence
Machine learning
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