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机器学习辅助中风预测在机械循环支持:系统性线粒体功能障碍的预测作用.

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概括

在LVAD植入之前,先前患有中风的患者显示线粒体功能障碍. 通过氧化酸化蛋白来测量这种功能障碍,可以预测CF-LVAD手术后的新中风.

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科学领域:

  • 心脏病学 心脏病学
  • 神经学 神经学
  • 线粒体生物学 线粒体生物学

背景情况:

  • 在接受连续流动左心室辅助器件 (CF-LVADs) 的高级充血性心力衰竭 (CHF) 患者中,中风风险很大.
  • 线粒体氧化酸化 (OxPhos) 异常与神经退行和脑缺血有关.

研究的目的:

  • 为了调查是否之前的中风与CF-LVAD患者的系统性线粒体OxPhos异常有关.
  • 为了确定这些异常在患有植入后新中风风险的患者中是否更明显.

主要方法:

  • 研究了50名CF-LVAD患者 (25人先前患有中风,25人没有).
  • 在CF-LVAD植入前和后的血白细胞中测量了OxPhos复合蛋白 (C.I-C.V).
  • 利用机器学习 (LASSO,随机森林) 进行中风预测建模.

主要成果:

  • 与没有中风的组相比,前中风组的OxPhos蛋白 (C.I,C.II,C.IV,C.V) 含量明显较低,无论是在CF-LVAD前后.
  • 在CF-LVAD后的中风前组中,OxPhos蛋白进一步下降.
  • 机器学习模型确定了六个预后因素,实现了0.93的AUC,用于预测术后中风.

结论:

  • 线粒体功能障碍,指的是外周OxPhos蛋白减少,存在于CHF患者之前的缺血性中风甚至在CF-LVAD植入之前.
  • 减少OxPhos蛋白表达可能作为CF-LVAD植入后新中风的预测生物标志物.