Zhang Jiajia, Zhang Heng, Wei Ting, Kang Pinfang, Tang Bi, Wang Hongju
Department of Cardiovascular Disease, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui Province, 233099, China.
Key Laboratory of Basic and Clinical Cardiovascular and Cerebrovascular Diseases, Bengbu Medical University, Bengbu, Anhui Province, 233030, China.
BMC Med Inform Decis Mak. 2024 Jul 31;24(1):217. doi: 10.1186/s12911-024-02620-1.
Exercise stress ECG is a common diagnostic test for stable coronary artery disease, but its sensitivity and specificity need to be further improved. In this paper, we construct a machine learning model for the prediction of angiographic coronary artery disease by HFQRS analysis of cycling exercise ECG.
This study prospectively included 140 inpatients and 59 healthy volunteers undergoing cycling exercise ECG. The CHD group (N=104) and non-CHD group (N=95) were determined by coronary angiography gold standard. Automated HF QRS analysis was performed by the blinded method. The coronary group was predominantly male, with a higher prevalence of age, BMI, hypertension, and diabetes than the non-coronary group ( ), higher lipid levels in the coronary group ( ), significantly longer QRS duration during exercise testing ( ), more positive leads ( ), and a greater proportion of significant changes in HFQRS ( ). Age, Gender, Hypertension, Diabetes, and HF QRS Conclusions were screened by correlation analysis and multifactorial retrospective analysis to construct the machine learning models of the XGBoost Classifier, Logistic Regression, LightGBM Classifier, RandomForest Classifier, Artificial Neural Network and Support Vector Machine, respectively.
Male, elderly, with hypertension, diabetes mellitus, and positive exercise stress test HFQRS conclusions suggested a high risk of CHD. The best performance of the Logistic Regression model was compared, and a column line graph for assessing the risk of CHD was further developed and validated.
运动应激心电图是稳定型冠状动脉疾病的常见诊断测试,但其敏感性和特异性有待进一步提高。本文通过对骑行运动心电图进行高频QRS分析,构建用于预测冠状动脉造影性冠心病的机器学习模型。
本研究前瞻性纳入了140例接受骑行运动心电图检查的住院患者和59名健康志愿者。通过冠状动脉造影金标准确定冠心病组(N = 104)和非冠心病组(N = 95)。采用盲法进行自动高频QRS分析。冠心病组以男性为主,年龄、体重指数、高血压和糖尿病的患病率高于非冠心病组( ),冠心病组血脂水平更高( ),运动试验期间QRS持续时间明显更长( ),阳性导联更多( ),高频QRS显著变化的比例更大( )。通过相关性分析和多因素回顾性分析筛选年龄、性别、高血压、糖尿病和高频QRS结论,分别构建XGBoost分类器、逻辑回归、LightGBM分类器、随机森林分类器、人工神经网络和支持向量机的机器学习模型。
男性、老年人、患有高血压、糖尿病且运动应激试验高频QRS结论为阳性提示冠心病风险高。比较了逻辑回归模型的最佳性能,并进一步开发和验证了用于评估冠心病风险的柱状线图。