Department of Engineering, University of Oxford, Oxford, United Kingdom; IBM Research, Kenya.
Department of Engineering, University of Oxford, Oxford, United Kingdom.
Artif Intell Med. 2021 Nov;121:102192. doi: 10.1016/j.artmed.2021.102192. Epub 2021 Oct 12.
Myocardial Infarction (MI) has the highest mortality of all cardiovascular diseases (CVDs). Detection of MI and information regarding its occurrence-time in particular, would enable timely interventions that may improve patient outcomes, thereby reducing the global rise in CVD deaths. Electrocardiogram (ECG) recordings are currently used to screen MI patients. However, manual inspection of ECGs is time-consuming and prone to subjective bias. Machine learning methods have been adopted for automated ECG diagnosis, but most approaches require extraction of ECG beats or consider leads independently of one another. We propose an end-to-end deep learning approach, DeepMI, to classify MI from Normal cases as well as identifying the time-occurrence of MI (defined as Acute, Recent and Old), using a collection of fusion strategies on 12 ECG leads at data-, feature-, and decision-level. In order to minimise computational overhead, we employ transfer learning using existing computer vision networks. Moreover, we use recurrent neural networks to encode the longitudinal information inherent in ECGs. We validated DeepMI on a dataset collected from 17,381 patients, in which over 323,000 samples were extracted per ECG lead. We were able to classify Normal cases as well as Acute, Recent and Old onset cases of MI, with AUROCs of 96.7%, 82.9%, 68.6% and 73.8%, respectively. We have demonstrated a multi-lead fusion approach to detect the presence and occurrence-time of MI. Our end-to-end framework provides flexibility for different levels of multi-lead ECG fusion and performs feature extraction via transfer learning.
心肌梗死 (MI) 是所有心血管疾病 (CVD) 中死亡率最高的疾病。检测 MI 及其发生时间,特别是能够及时进行干预,可能改善患者的预后,从而降低 CVD 死亡人数在全球的上升。心电图 (ECG) 记录目前用于筛选 MI 患者。然而,手动检查 ECG 既耗时又容易受到主观偏见的影响。机器学习方法已被用于自动 ECG 诊断,但大多数方法需要提取 ECG 节拍或独立考虑导联。我们提出了一种端到端的深度学习方法 DeepMI,用于对正常和 MI 病例进行分类,以及识别 MI 的时间发生(定义为急性、近期和陈旧性),使用 12 个 ECG 导联在数据、特征和决策级别上的融合策略。为了最小化计算开销,我们使用现有的计算机视觉网络进行迁移学习。此外,我们使用循环神经网络来编码 ECG 中固有的纵向信息。我们在一个从 17381 名患者中收集的数据集中验证了 DeepMI,其中每个 ECG 导联提取了超过 323000 个样本。我们能够对正常病例以及急性、近期和陈旧性 MI 病例进行分类,其 AUC 分别为 96.7%、82.9%、68.6%和 73.8%。我们已经证明了一种多导联融合方法来检测 MI 的存在和发生时间。我们的端到端框架为不同级别的多导联 ECG 融合提供了灵活性,并通过迁移学习进行特征提取。