人工智能增强风险分层与癌症治疗相关的心脏功能障碍使用心电图像
Evangelos K Oikonomou1, Veer Sangha1,2, Lovedeep S Dhingra1
1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
medRxiv : the preprint server for health sciences
|April 2, 2024
概括
应用于心电图 (ECG) 的人工智能 (AI) 可以预测接受特定治疗的癌症患者的心脏功能障碍. 这个AI-ECG工具提供了一个可扩展的风险分层方法,改善了对心脏毒性的患者监测.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 人工智能的人工智能
背景情况:
- 癌症治疗药物,如 antracyclines (AC) 和 trastuzumab (TZM),可以导致心脏功能障碍 (CTRCD).
- 目前的风险分层依赖于专门的成像,其具有可扩展性的限制.
- 需要可访问的方法来识别患有CTRCD高风险的患者.
研究的目的:
- 评估一个人工智能 (AI) 增强的心电图 (AI-ECG) 工具作为CTRCD风险的成像生物标志物的替代品.
- 评估AI-ECG预测与癌症患者中CTRCD的发展之间的关联.
主要方法:
- 一个验证的AI模型用于左心室缩功能障碍 (LVSD) 被应用于接受 antracyclines (AC),trastuzumab (TZM) 或免疫检查点抑制剂 (ICI) 的患者的心电图.
- AI-ECG LVSD预测与全球纵向应变 (GLS) 和未来的CTRCD事件 (心肌病,心力衰竭,LVEF<50%或<40%) 相相关.
- 还检查了AI-ECG预测和ICI相关心肌炎之间的关联.
主要成果:
- 更高的AI-ECG LVSD预测与减少的GLS相关.
- 在接受AC/TZM治疗的患者中,阳性AI-ECG LVSD屏幕与复合CTRCD风险增加约2倍,LVEF风险增加约4.8倍<40%.
- AI-ECG预测没有显示与ICI相关心肌炎的关联.
结论:
- 应用于基线心电图像的AI可以有效地对接受AC或TZM癌症治疗的患者中CTRCD的风险进行分层.
- AI-ECG提供了一个有希望的,可扩展的工具,用于早期评估瘤病人的心脏毒性风险.
- 进一步的研究可能会探索AI-ECG在监测其他心脏毒性疗法的作用.
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