Chen Zhihao, Shi Jixi, Pommier Thibaut, Cottin Yves, Salomon Michel, Decourselle Thomas, Lalande Alain, Couturier Raphaël
FEMTO-ST Institute, UMR 6174 CNRS, Univ. Bourgogne Franche-Comté, Belfort, France.
IRSEEM, EA 4353, ESIGELEC, Univ. Normandie, Saint-Étienne-du-Rouvray, France.
Front Cardiovasc Med. 2022 Mar 14;9:754609. doi: 10.3389/fcvm.2022.754609. eCollection 2022.
This study proposes machine learning-based models to automatically evaluate the severity of myocardial infarction (MI) from physiological, clinical, and paraclinical features. Two types of machine learning models are investigated for the MI assessment: the classification models classify the presence of the infarct and the persistent microvascular obstruction (PMO), and the regression models quantify the Percentage of Infarcted Myocardium (PIM) of patients suspected of having an acute MI during their reception in the emergency department. The ground truth labels for these supervised models are derived from the corresponding Delayed Enhancement MRI (DE-MRI) exams and manual annotations of the myocardium and scar tissues. Experiments were conducted on 150 cases and evaluated with cross-validation. Results showed that for the MI (PMO inclusive) and the PMO (infarct exclusive), the best models obtained respectively a mean error of 0.056 and 0.012 for the quantification, and 88.67 and 77.33% for the classification accuracy of the state of the myocardium. The study of the features' importance also revealed that the troponin value had the strongest correlation to the severity of the MI among the 12 selected features. For the proposal's translational perspective, in cardiac emergencies, qualitative and quantitative analysis can be obtained prior to the achievement of MRI by relying only on conventional tests and patient features, thus, providing an objective reference for further treatment by physicians.
本研究提出了基于机器学习的模型,以根据生理、临床和辅助临床特征自动评估心肌梗死(MI)的严重程度。研究了两种用于MI评估的机器学习模型:分类模型对梗死灶和持续性微血管阻塞(PMO)的存在进行分类,回归模型对疑似急性MI患者在急诊科就诊时的梗死心肌百分比(PIM)进行量化。这些监督模型的真实标签来自相应的延迟强化磁共振成像(DE-MRI)检查以及心肌和瘢痕组织的手动标注。对150例病例进行了实验,并采用交叉验证进行评估。结果表明,对于MI(包括PMO)和PMO(不包括梗死灶),最佳模型在量化方面分别获得了0.056和0.012的平均误差,在心肌状态分类准确率方面分别为88.67%和77.33%。对特征重要性的研究还表明,在所选择的12个特征中,肌钙蛋白值与MI严重程度的相关性最强。从该提议的转化角度来看,在心脏急症中,仅依靠传统检查和患者特征,在进行MRI检查之前即可获得定性和定量分析结果,从而为医生的进一步治疗提供客观参考。