Artificial intelligence-enabled fully automated detection of cardiac amyloidosis using electrocardiograms and echocardiograms.

Journal: Nature communications
Published Date:

Abstract

Patients with rare conditions such as cardiac amyloidosis (CA) are difficult to identify, given the similarity of disease manifestations to more prevalent disorders. The deployment of approved therapies for CA has been limited by delayed diagnosis of this disease. Artificial intelligence (AI) could enable detection of rare diseases. Here we present a pipeline for CA detection using AI models with electrocardiograms (ECG) or echocardiograms as inputs. These models, trained and validated on 3 and 5 academic medical centers (AMC) respectively, detect CA with C-statistics of 0.85-0.91 for ECG and 0.89-1.00 for echocardiography. Simulating deployment on 2 AMCs indicated a positive predictive value (PPV) for the ECG model of 3-4% at 52-71% recall. Pre-screening with ECG enhance the echocardiography model performance at 67% recall from PPV of 33% to PPV of 74-77%. In conclusion, we developed an automated strategy to augment CA detection, which should be generalizable to other rare cardiac diseases.

Authors

  • Shinichi Goto
    Division of General Internal Medicine & Family Medicine, Department of General and Acute Medicine, Tokai University School of Medicine, Isehara, Japan.
  • Keitaro Mahara
    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
  • Lauren Beussink-Nelson
    Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Hidehiko Ikura
    Department of Cardiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
  • Yoshinori Katsumata
    Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
  • Jin Endo
    Department of Cardiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
  • Hanna K Gaggin
    Cardiology Division, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
  • Sanjiv J Shah
    Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Yuji Itabashi
    Department of Cardiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
  • Calum A MacRae
    One Brave Idea and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
  • Rahul C Deo
    From the Division of Cardiology, Department of Medicine; Cardiovascular Research Institute; Institute for Human Genetics; and Institute for Computational Health Sciences, University of California San Francisco, and California Institute for Quantitative Biosciences (R.C.D.); and VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI; Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (B.K.N.). rahul.deo@ucsf.edu.