Liu Lu, Qiao Cen, Zha Jun-Ren, Qin Huan, Wang Xiao-Rui, Zhang Xin-Yu, Wang Yi-Ou, Yang Xiu-Mei, Zhang Shu-Long, Qin Jing
Heart Centre, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
School of Software Engineering, Dalian University, Dalian, China.
Front Cardiovasc Med. 2022 Aug 17;9:864312. doi: 10.3389/fcvm.2022.864312. eCollection 2022.
At present, there is no early prediction model of left ventricular reverse remodeling (LVRR) for people who are in cardiac arrest with an ejection fraction (EF) of ≤35% at first diagnosis; thus, the purpose of this article is to provide a supplement to existing research.
A total of 109 patients suffering from heart attack with an EF of ≤35% at first diagnosis were involved in this single-center research study. LVRR was defined as an absolute increase in left ventricular ejection fraction (LVEF) from ≥10% to a final value of >35%, with analysis features including demographic characteristics, diseases, biochemical data, echocardiography, and drug therapy. Extreme gradient boosting (XGBoost), random forest, and logistic regression algorithm models were used to distinguish between LVRR and non-LVRR cases and to obtain the most important features.
There were 47 cases (42%) of LVRR in patients suffering from heart failure with an EF of ≤35% at first diagnosis after optimal drug therapy. General statistical analysis and machine learning methods were combined to exclude a number of significant feature groups. The median duration of disease in the LVRR group was significantly lower than that in the non-LVRR group (7 vs. 48 months); the mean values of creatine kinase (CK) and MB isoenzyme of creatine kinase (CK-MB) in the LVRR group were lower than those in the non-LVRR group (80.11 vs. 94.23 U/L; 2.61 vs. 2.99 ng/ml; 27.19 vs. 28.54 mm). Moreover, AUC values for our feature combinations ranged from 97 to 94% and to 87% when using the XGBoost, random forest, and logistic regression techniques, respectively. The ablation test revealed that beats per minute (BPM) and disease duration had a greater impact on the model's ability to accurately forecast outcomes.
Shorter disease duration, slightly lower CK and CK-MB levels, slightly smaller right and left ventricular and left atrial dimensions, and lower mean heart rates were found to be most strongly predictive of LVRR development (BPM).
目前,对于首次诊断时射血分数(EF)≤35%的心脏骤停患者,尚无左心室逆向重构(LVRR)的早期预测模型;因此,本文旨在对现有研究进行补充。
本单中心研究纳入了109例首次诊断时EF≤35%的心脏病发作患者。LVRR定义为左心室射血分数(LVEF)绝对增加≥10%,最终值>35%,分析特征包括人口统计学特征、疾病、生化数据、超声心动图和药物治疗。采用极端梯度提升(XGBoost)、随机森林和逻辑回归算法模型区分LVRR和非LVRR病例,并获取最重要的特征。
在首次诊断时EF≤35%的心力衰竭患者中,经过最佳药物治疗后,有47例(42%)发生LVRR。综合运用一般统计分析和机器学习方法排除了一些重要特征组。LVRR组的疾病中位持续时间显著低于非LVRR组(7个月对48个月);LVRR组的肌酸激酶(CK)和肌酸激酶MB同工酶(CK-MB)平均值低于非LVRR组(80.11对94.23 U/L;2.61对2.99 ng/ml;27.19对28.54 mm)。此外,当分别使用XGBoost、随机森林和逻辑回归技术时,我们的特征组合的AUC值分别为97%至94%和87%。消融试验表明,每分钟心跳次数(BPM)和疾病持续时间对模型准确预测结果的能力影响更大。
发现疾病持续时间较短、CK和CK-MB水平略低、左右心室及左心房尺寸略小以及平均心率较低最能强烈预测LVRR的发生(BPM)。