The Effectiveness of a Deep Learning Model to Detect Left Ventricular Systolic Dysfunction from Electrocardiograms.

Journal: International heart journal
PMID:

Abstract

Deep learning models can be applied to electrocardiograms (ECGs) to detect left ventricular (LV) dysfunction. We hypothesized that applying a deep learning model may improve the diagnostic accuracy of cardiologists in predicting LV dysfunction from ECGs. We acquired 37,103 paired ECG and echocardiography data records of patients who underwent echocardiography between January 2015 and December 2019. We trained a convolutional neural network to identify the data records of patients with LV dysfunction (ejection fraction < 40%) using a dataset of 23,801 ECGs. When tested on an independent set of 7,196 ECGs, we found the area under the receiver operating characteristic curve was 0.945 (95% confidence interval: 0.936-0.954). When 7 cardiologists interpreted 50 randomly selected ECGs from the test dataset of 7,196 ECGs, their accuracy for predicting LV dysfunction was 78.0% ± 6.0%. By referring to the model's output, the cardiologist accuracy improved to 88.0% ± 3.7%, which indicates that model support significantly improved the cardiologist diagnostic accuracy (P = 0.02). A sensitivity map demonstrated that the model focused on the QRS complex when detecting LV dysfunction on ECGs. We developed a deep learning model that can detect LV dysfunction on ECGs with high accuracy. Furthermore, we demonstrated that support from a deep learning model can help cardiologists to identify LV dysfunction on ECGs.

Authors

  • Susumu Katsushika
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Satoshi Kodera
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Mitsuhiko Nakamoto
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Kota Ninomiya
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Shunsuke Inoue
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Shinnosuke Sawano
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Nobutaka Kakuda
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Hiroshi Takiguchi
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Hiroki Shinohara
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Ryo Matsuoka
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Hirotaka Ieki
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Yasutomi Higashikuni
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Koki Nakanishi
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Tomoko Nakao
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Tomohisa Seki
    Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
  • Norifumi Takeda
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Katsuhito Fujiu
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Masao Daimon
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Hiroshi Akazawa
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Hiroyuki Morita
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Issei Komuro
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.