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 genera...
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ftlshtm:oai:researchonline.lshtm.ac.uk:4664392 2024-06-23T07:56:33+00:00 Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. Brito, Bruno Oliveira de Figueiredo Attia, Zachi I Martins, Larissa Natany A Perel, Pablo Nunes, Maria Carmo P Sabino, Ester Cerdeira Cardoso, Clareci Silva Ferreira, Ariela Mota Gomes, Paulo R Luiz Pinho Ribeiro, Antonio Lopez-Jimenez, Francisco 2021-12-01 text https://researchonline.lshtm.ac.uk/id/eprint/4664392/ https://researchonline.lshtm.ac.uk/id/eprint/4664392/1/Left%20ventricular%20systolic%20dysfunction%20predicted%20by%20artificial%20intelligence%20using%20the%20electrocardiogram%20in%20Chagas%20disease%20pat.pdf en eng PUBLIC LIBRARY SCIENCE https://researchonline.lshtm.ac.uk/id/eprint/4664392/1/Left%20ventricular%20systolic%20dysfunction%20predicted%20by%20artificial%20intelligence%20using%20the%20electrocardiogram%20in%20Chagas%20disease%20pat.pdf Brito, Bruno Oliveira de Figueiredo; Attia, Zachi I; Martins, Larissa Natany A; Perel, Pablo <https://researchonline.lshtm.ac.uk/view/creators/enphpper.html>; Nunes, Maria Carmo P; Sabino, Ester Cerdeira; Cardoso, Clareci Silva; Ferreira, Ariela Mota; Gomes, Paulo R; Luiz Pinho Ribeiro, Antonio; +1 more. Lopez-Jimenez, Francisco; (2021) Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. PLOS NEGLECTED TROPICAL DISEASES, 15 (12). e0009974-. ISSN 1935-2735 DOI: https://doi.org/10.1371/journal.pntd.0009974 <https://doi.org/10.1371/journal.pntd.0009974> cc_by_4 Article PeerReviewed 2021 ftlshtm https://doi.org/10.1371/journal.pntd.0009974 2024-06-04T14:21:40Z 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 sami London School of Hygiene & Tropical Medicine: LSHTM Research Online PLOS Neglected Tropical Diseases 15 12 e0009974 |
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London School of Hygiene & Tropical Medicine: LSHTM Research Online |
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language |
English |
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 |
Brito, Bruno Oliveira de Figueiredo Attia, Zachi I Martins, Larissa Natany A Perel, Pablo Nunes, Maria Carmo P Sabino, Ester Cerdeira Cardoso, Clareci Silva Ferreira, Ariela Mota Gomes, Paulo R Luiz Pinho Ribeiro, Antonio Lopez-Jimenez, Francisco |
spellingShingle |
Brito, Bruno Oliveira de Figueiredo Attia, Zachi I Martins, Larissa Natany A Perel, Pablo Nunes, Maria Carmo P Sabino, Ester Cerdeira Cardoso, Clareci Silva Ferreira, Ariela Mota Gomes, Paulo R Luiz Pinho Ribeiro, Antonio Lopez-Jimenez, Francisco Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. |
author_facet |
Brito, Bruno Oliveira de Figueiredo Attia, Zachi I Martins, Larissa Natany A Perel, Pablo Nunes, Maria Carmo P Sabino, Ester Cerdeira Cardoso, Clareci Silva Ferreira, Ariela Mota Gomes, Paulo R Luiz Pinho Ribeiro, Antonio Lopez-Jimenez, Francisco |
author_sort |
Brito, Bruno Oliveira de Figueiredo |
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 SCIENCE |
publishDate |
2021 |
url |
https://researchonline.lshtm.ac.uk/id/eprint/4664392/ https://researchonline.lshtm.ac.uk/id/eprint/4664392/1/Left%20ventricular%20systolic%20dysfunction%20predicted%20by%20artificial%20intelligence%20using%20the%20electrocardiogram%20in%20Chagas%20disease%20pat.pdf |
genre |
sami |
genre_facet |
sami |
op_relation |
https://researchonline.lshtm.ac.uk/id/eprint/4664392/1/Left%20ventricular%20systolic%20dysfunction%20predicted%20by%20artificial%20intelligence%20using%20the%20electrocardiogram%20in%20Chagas%20disease%20pat.pdf Brito, Bruno Oliveira de Figueiredo; Attia, Zachi I; Martins, Larissa Natany A; Perel, Pablo <https://researchonline.lshtm.ac.uk/view/creators/enphpper.html>; Nunes, Maria Carmo P; Sabino, Ester Cerdeira; Cardoso, Clareci Silva; Ferreira, Ariela Mota; Gomes, Paulo R; Luiz Pinho Ribeiro, Antonio; +1 more. Lopez-Jimenez, Francisco; (2021) Left ventricular systolic dysfunction predicted by artificial intelligence using the electrocardiogram in Chagas disease patients-The SaMi-Trop cohort. PLOS NEGLECTED TROPICAL DISEASES, 15 (12). e0009974-. ISSN 1935-2735 DOI: https://doi.org/10.1371/journal.pntd.0009974 <https://doi.org/10.1371/journal.pntd.0009974> |
op_rights |
cc_by_4 |
op_doi |
https://doi.org/10.1371/journal.pntd.0009974 |
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