可解释的独立循环网络用于预测心房动中风
Jung-Chi Hsu1, Yi-Hsien Hsieh2, Yen-Yun Yang3
1Department of Internal Medicine, National Taiwan University Hospital Jinshan Branch, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
JACC. Asia
|June 11, 2025
概括
一种名为ForeSIIN的新模型准确地预测了心房动 (AF) 患者中风风险. 这种先进的工具可以解释随着时间的推移动态的风险因素,从而改善患者的护理.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 人工智能在医学中的应用
背景情况:
- 心房动 (AF) 是暂时性缺血性发作 (TIA) 和缺血性中风 (IS) 的重要危险因素.
- 准确预测IS风险对于管理AF患者至关重要.
研究的目的:
- 开发和验证一个高维时间序列模型,用于预测AF患者的IS风险.
- 通过结合动态时间数据来改进现有的风险预测模型.
主要方法:
- 一项队列研究包括7710名AF患者 (2014-2019),对6822名患者进行了外部验证.
- 通过可解释的独立网络 (ForeSIIN) 开发了预测冲击模型,利用封闭的循环单位.
- 卡普兰-梅尔分析和日志等级测试评估了风险组差异.
主要成果:
- ForeSIIN模型实现了0.764的AUC,超过了CHA2DS2-VASc得分 (AUC:0.650) 和其他非顺序模型.
- 通过外部验证,AUC值为0.646.6.
- 确定的关键预测因素包括TIA/IS,eGFR,C反应蛋白,血红素和血快食葡萄糖的病史.
结论:
- 该ForeSIIN模型在AF患者中提供准确的中风预测.
- 这种创新模型可以提高对随时间推移的动态风险因素的解释.
相关概念视频
The Cardiac Cycle
The heart beats rhythmically in a sequence called the cardiac cycle—a rapid coordination of contraction (systole) and relaxation (diastole).
The Process
Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and empty blood into the...
The Process
Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and empty blood into the...
Pulse rhythm
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...
Factors Influencing Heart Rate
The heart rate, or pulse rate, is a vital indicator of cardiovascular health. It reflects the number of times the heart beats per minute. Various physiological and environmental factors influence heart rate, increasing or decreasing cardiac output. Understanding these factors is crucial for assessing heart function and identifying potential health issues.
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
Let us explore the significant factors affecting heart rate, including age, body temperature, posture, acute pain, chemical influences,...
Mechanism of Cardiac Arrhythmias
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
Node Analysis for AC Circuits
Consider an angioplasty system featuring a catheter equipped with a turbine, a critical tool for removing plaque deposits from coronary arteries. This intricate medical device operates using a circuit model reminiscent of a dual-node RLC circuit powered by a current-controlled voltage source.
To unravel the complexities of this system, nodal analysis is employed, a powerful technique founded on Kirchhoff's current law (KCL), which remains valid for phasors. AC circuits can effectively be...
To unravel the complexities of this system, nodal analysis is employed, a powerful technique founded on Kirchhoff's current law (KCL), which remains valid for phasors. AC circuits can effectively be...
Correlation between ECG and Cardiac Cycle
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...


