Yilmaz Rustem, Öz Ersoy
Department of Cardiology, Faculty of Medicine, Samsun University, Samsun 33805, Turkey.
Department of Statistics, Yildiz Technical University, Istanbul 34220, Turkey.
Diagnostics (Basel). 2023 Oct 16;13(20):3221. doi: 10.3390/diagnostics13203221.
Heart failure (HF) causes high morbidity and mortality worldwide. The prevalence of HF with preserved ejection fraction (HFpEF) is increasing compared with HF with reduced ejection fraction (HFrEF). Patients with HFpEF are a patient group with a high rate of hospitalization despite medical treatment. Early diagnosis is very important in this group of patients, and early treatment can improve their prognosis. Although electrocardiographic (ECG) findings have been adequately studied in patients with HFrEF, there are not enough studies on these parameters in patients with HFpEF. There are very few studies in the literature, especially on gender-specific changes. The current research aims to compare gender-specific ECG parameters in patients with HFpEF based on the implications of artificial intelligence (AI).
A total of 118 patients participated in the study, of which 66 (56%) were women with HFpEF and 52 (44%) were men with HFpEF. Demographic, echocardiographic, and electrocardiographic characteristics of the patients were analyzed to compare gender-specific ECG parameters in patients with HFpEF. The AI approach combined with machine learning approaches (gradient boosting machine, k-nearest neighbors, logistic regression, random forest, and support vector machines) was applied for distinguishing male patients with HFpEF from female patients with HFpEF.
After determining the parameters (demographic, echocardiographic, and electrocardiographic) to distinguish male patients with HFpEF from female patients with HFpEF, machine learning methods were applied, and among these methods, the random forest model achieved an average accuracy of 84.7%. The random forest algorithm results showed that smoking, P-wave dispersion, P-wave amplitude, T-end P/(PQ*Age), Cornell product, and P-wave duration were the most influential parameters for distinguishing male patients with HFpEF from female patients with HFpEF.
The proposed model serves as a valuable tool for physicians, facilitating the diagnosis, treatment, and follow-up for distinguishing male patients with HFpEF from female patients with HFpEF. Analyzing readily accessible electrocardiographic parameters empowers medical professionals to make informed decisions and provide enhanced care to a wide range of individuals.
心力衰竭(HF)在全球范围内导致高发病率和死亡率。与射血分数降低的心力衰竭(HFrEF)相比,射血分数保留的心力衰竭(HFpEF)的患病率正在上升。尽管接受了药物治疗,但HFpEF患者仍是住院率很高的患者群体。早期诊断对这组患者非常重要,早期治疗可以改善他们的预后。虽然心电图(ECG)检查结果在HFrEF患者中已有充分研究,但在HFpEF患者中对这些参数的研究还不够。文献中的研究很少,尤其是关于性别特异性变化的研究。当前的研究旨在基于人工智能(AI)的影响比较HFpEF患者的性别特异性心电图参数。
共有118名患者参与了该研究,其中66名(56%)为女性HFpEF患者,52名(44%)为男性HFpEF患者。分析患者的人口统计学、超声心动图和心电图特征,以比较HFpEF患者的性别特异性心电图参数。采用人工智能方法结合机器学习方法(梯度提升机、k近邻、逻辑回归、随机森林和支持向量机)来区分男性HFpEF患者和女性HFpEF患者。
在确定区分男性HFpEF患者和女性HFpEF患者的参数(人口统计学、超声心动图和心电图)后,应用了机器学习方法,在这些方法中,随机森林模型的平均准确率达到了84.7%。随机森林算法的结果表明,吸烟、P波离散度、P波振幅、T波终末P/(PQ*年龄)、康奈尔乘积和P波持续时间是区分男性HFpEF患者和女性HFpEF患者最具影响力的参数。
所提出的模型为医生提供了一个有价值的工具,便于对男性HFpEF患者和女性HFpEF患者进行诊断、治疗和随访。分析易于获得的心电图参数使医疗专业人员能够做出明智的决策,并为广泛的个体提供更好的护理。