Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort.
Background Left ventricular systolic dysfunction (LVSD) in Chagas disease (ChD) is relatively common and its treatment using low-cost drugs can improve symptoms and reduce mortality. Recently, an artificial intelligence (AI)-enabled ECG algorithm showed excellent accuracy to detect LVSD in a general...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2021
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0009974 https://doaj.org/article/4a9e105afca0448e9ce7623766076c1f |
id |
ftdoajarticles:oai:doaj.org/article:4a9e105afca0448e9ce7623766076c1f |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:4a9e105afca0448e9ce7623766076c1f 2023-05-15T15:16:45+02:00 Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. Bruno Oliveira de Figueiredo Brito Zachi I Attia Larissa Natany A Martins Pablo Perel Maria Carmo P Nunes Ester Cerdeira Sabino Clareci Silva Cardoso Ariela Mota Ferreira Paulo R Gomes Antonio Luiz Pinho Ribeiro Francisco Lopez-Jimenez 2021-12-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0009974 https://doaj.org/article/4a9e105afca0448e9ce7623766076c1f EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0009974 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009974 https://doaj.org/article/4a9e105afca0448e9ce7623766076c1f PLoS Neglected Tropical Diseases, Vol 15, Iss 12, p e0009974 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0009974 2022-12-31T03:05:34Z Background Left ventricular systolic dysfunction (LVSD) in Chagas disease (ChD) is relatively common and its treatment using low-cost drugs can improve symptoms and reduce mortality. Recently, an artificial intelligence (AI)-enabled ECG algorithm showed excellent accuracy to detect LVSD in a general population, but its accuracy in ChD has not been tested. Objective To analyze the ability of AI to recognize LVSD in patients with ChD, defined as a left ventricular ejection fraction determined by the Echocardiogram ≤ 40%. Methodology/principal findings This is a cross-sectional study of ECG obtained from a large cohort of patients with ChD named São Paulo-Minas Gerais Tropical Medicine Research Center (SaMi-Trop) Study. The digital ECGs of the participants were submitted to the analysis of the trained machine to detect LVSD. The diagnostic performance of the AI-enabled ECG to detect LVSD was tested using an echocardiogram as the gold standard to detect LVSD, defined as an ejection fraction <40%. The model was enriched with NT-proBNP plasma levels, male sex, and QRS ≥ 120ms. Among the 1,304 participants of this study, 67% were women, median age of 60; there were 93 (7.1%) individuals with LVSD. Most patients had major ECG abnormalities (59.5%). The AI algorithm identified LVSD among ChD patients with an odds ratio of 63.3 (95% CI 32.3-128.9), a sensitivity of 73%, a specificity of 83%, an overall accuracy of 83%, and a negative predictive value of 97%; the AUC was 0.839. The model adjusted for the male sex and QRS ≥ 120ms improved the AUC to 0.859. The model adjusted for the male sex and elevated NT-proBNP had a higher accuracy of 0.89 and an AUC of 0.874. Conclusion The AI analysis of the ECG of Chagas disease patients can be transformed into a powerful tool for the recognition of LVSD. Article in Journal/Newspaper Arctic sami Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 12 e0009974 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Bruno Oliveira de Figueiredo Brito Zachi I Attia Larissa Natany A Martins Pablo Perel Maria Carmo P Nunes Ester Cerdeira Sabino Clareci Silva Cardoso Ariela Mota Ferreira Paulo R Gomes Antonio Luiz Pinho Ribeiro Francisco Lopez-Jimenez Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Left ventricular systolic dysfunction (LVSD) in Chagas disease (ChD) is relatively common and its treatment using low-cost drugs can improve symptoms and reduce mortality. Recently, an artificial intelligence (AI)-enabled ECG algorithm showed excellent accuracy to detect LVSD in a general population, but its accuracy in ChD has not been tested. Objective To analyze the ability of AI to recognize LVSD in patients with ChD, defined as a left ventricular ejection fraction determined by the Echocardiogram ≤ 40%. Methodology/principal findings This is a cross-sectional study of ECG obtained from a large cohort of patients with ChD named São Paulo-Minas Gerais Tropical Medicine Research Center (SaMi-Trop) Study. The digital ECGs of the participants were submitted to the analysis of the trained machine to detect LVSD. The diagnostic performance of the AI-enabled ECG to detect LVSD was tested using an echocardiogram as the gold standard to detect LVSD, defined as an ejection fraction <40%. The model was enriched with NT-proBNP plasma levels, male sex, and QRS ≥ 120ms. Among the 1,304 participants of this study, 67% were women, median age of 60; there were 93 (7.1%) individuals with LVSD. Most patients had major ECG abnormalities (59.5%). The AI algorithm identified LVSD among ChD patients with an odds ratio of 63.3 (95% CI 32.3-128.9), a sensitivity of 73%, a specificity of 83%, an overall accuracy of 83%, and a negative predictive value of 97%; the AUC was 0.839. The model adjusted for the male sex and QRS ≥ 120ms improved the AUC to 0.859. The model adjusted for the male sex and elevated NT-proBNP had a higher accuracy of 0.89 and an AUC of 0.874. Conclusion The AI analysis of the ECG of Chagas disease patients can be transformed into a powerful tool for the recognition of LVSD. |
format |
Article in Journal/Newspaper |
author |
Bruno Oliveira de Figueiredo Brito Zachi I Attia Larissa Natany A Martins Pablo Perel Maria Carmo P Nunes Ester Cerdeira Sabino Clareci Silva Cardoso Ariela Mota Ferreira Paulo R Gomes Antonio Luiz Pinho Ribeiro Francisco Lopez-Jimenez |
author_facet |
Bruno Oliveira de Figueiredo Brito Zachi I Attia Larissa Natany A Martins Pablo Perel Maria Carmo P Nunes Ester Cerdeira Sabino Clareci Silva Cardoso Ariela Mota Ferreira Paulo R Gomes Antonio Luiz Pinho Ribeiro Francisco Lopez-Jimenez |
author_sort |
Bruno Oliveira de Figueiredo Brito |
title |
Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. |
title_short |
Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. |
title_full |
Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. |
title_fullStr |
Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. |
title_full_unstemmed |
Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. |
title_sort |
left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in chagas disease patients-the sami-trop cohort. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0009974 https://doaj.org/article/4a9e105afca0448e9ce7623766076c1f |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic sami |
genre_facet |
Arctic sami |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 12, p e0009974 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0009974 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009974 https://doaj.org/article/4a9e105afca0448e9ce7623766076c1f |
op_doi |
https://doi.org/10.1371/journal.pntd.0009974 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
15 |
container_issue |
12 |
container_start_page |
e0009974 |
_version_ |
1766347050431021056 |