Department of Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong Province, China.
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Eur J Radiol. 2019 Aug;117:178-183. doi: 10.1016/j.ejrad.2019.06.004. Epub 2019 Jun 11.
Dilated cardiomyopathy (DCM) is a common form of cardiomyopathy and it is associated with poor outcomes. A poor prognosis of DCM patients with low ejection fraction has been noted in the short-term follow-up. Machine learning (ML) could aid clinicians in risk stratification and patient management after considering the correlation between numerous features and the outcomes. The present study aimed to predict the 1-year cardiovascular events in patients with severe DCM using ML, and aid clinicians in risk stratification and patient management.
The dataset used to establish the ML model was obtained from 98 patients with severe DCM (LVEF < 35%) from two centres. Totally 32 features from clinical data were input to the ML algorithm, and the significant features highly relevant to the cardiovascular events were selected by Information gain (IG). A naive Bayes classifier was built, and its predictive performance was evaluated using the area under the curve (AUC) of the receiver operating characteristics by 10-fold cross-validation.
During the 1-year follow-up, a total of 22 patients met the criterion of the study end-point. The top features with IG > 0.01 were selected for ML model, including left atrial size (IG = 0.240), QRS duration (IG = 0.200), and systolic blood pressure (IG = 0.151). ML performed well in predicting cardiovascular events in patients with severe DCM (AUC, 0.887 [95% confidence interval, 0.813-0.961]).
ML effectively predicted risk in patients with severe DCM in 1-year follow-up, and this may direct risk stratification and patient management in the future.
扩张型心肌病(DCM)是一种常见的心肌病,与不良预后相关。在短期随访中,已注意到射血分数较低的 DCM 患者预后较差。考虑到众多特征与结局之间的相关性,机器学习(ML)可以帮助临床医生进行风险分层和患者管理。本研究旨在使用 ML 预测严重 DCM 患者的 1 年心血管事件,并帮助临床医生进行风险分层和患者管理。
用于建立 ML 模型的数据集来自两个中心的 98 例严重 DCM 患者(LVEF<35%)。总共从临床数据中输入 32 个特征到 ML 算法中,通过信息增益(IG)选择与心血管事件高度相关的显著特征。建立了朴素贝叶斯分类器,并通过 10 折交叉验证的接收者操作特征曲线下面积(AUC)评估其预测性能。
在 1 年随访期间,共有 22 例患者达到了研究终点的标准。IG>0.01 的顶级特征被选为 ML 模型的特征,包括左心房大小(IG=0.240)、QRS 持续时间(IG=0.200)和收缩压(IG=0.151)。ML 在预测严重 DCM 患者的心血管事件方面表现良好(AUC,0.887[95%置信区间,0.813-0.961])。
ML 有效预测了 1 年随访中严重 DCM 患者的风险,这可能指导未来的风险分层和患者管理。