利用动脉压波形评估左心室舒张时间常数。
Assessment of left ventricular relaxation time constant using arterial pressure waveform.
作者信息
Rafiei Deniz, Alavi Rashid, Matthews Ray V, Pahlevan Niema M
机构信息
Aerospace and Mechanical Engineering, University of Southern California Viterbi School of Engineering, 1002, Childs Way, Los Angeles, Los Angeles, California, 90089-0111, UNITED STATES.
Department of Aerospace and Mechanical Engineering, University of Southern California, 1002, Childs Way, Los Angeles, Los Angeles, California, 90089, UNITED STATES.
出版信息
Physiol Meas. 2025 Aug 13. doi: 10.1088/1361-6579/adfb1f.
Instantaneous determination of left ventricular (LV) diastolic function would be a useful aid in diagnosis and treatment of heart failure. The time constant of LV pressure decay (also known as Tau) is an established metric for evaluating LV stiffness and assessing LV diastolic function. Approach: In this study, we present a novel approach that uses a single arterial (aortic) pressure waveform to classify abnormal Tau through a physics-based machine learning (ML) methodology. This study is based on a clinical LV catheterization at the University of Southern California Keck Medical Center. We included 54 patients (13 females, age 36-90 (66.3±10.8), BMI 20.2-38.5 (27.8±4.6)) that were subjected to the same exclusion criteria of the primary study. Invasive pressure waveforms at LV and ascending aorta were measured using 2.5 F transducer tipped electronic micro-catheters. Intrinsic frequency (IF) parameters were computed from aortic pressure waveforms. Tau was calculated using an exponential curve-fitting approach based on LV pressure. Tau ranges were 25.7-86.5 ms (50.3±11), and Tau = 48 ms was used as a binary classification cut-off. Random forest and K-nearest neighbors classifiers were trained on 44 patients and blindly tested on 10 patients. 3- fold cross-validation was used to prevent overfitting. Main Results: Our proposed ML classifier model accurately predicts true Tau classes using physics-based features, where the most accurate one demonstrates 80.0% (elevated) and 100.0% (normal) success in predicting true Tau classes on blind data. Significance: We demonstrate that our proposed physics-based ML models can instantaneously classify Tau using information from a single aortic pressure waveform. Although an invasive proof, the required model inputs can be acquired non-invasively using carotid waveforms, working toward a smartphone-based, patient-activated tool for assessing diastolic dysfunction.
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即时测定左心室(LV)舒张功能将有助于心力衰竭的诊断和治疗。左心室压力衰减的时间常数(也称为Tau)是评估左心室僵硬度和左心室舒张功能的既定指标。
方法
在本研究中,我们提出了一种新颖的方法,该方法使用单个动脉(主动脉)压力波形,通过基于物理学的机器学习(ML)方法对异常Tau进行分类。本研究基于南加州大学凯克医学中心的临床左心室导管插入术。我们纳入了54名患者(13名女性,年龄36 - 90岁(66.3±10.8),体重指数20.2 - 38.5(27.8±4.6)),这些患者均符合主要研究的相同排除标准。使用2.5F传感器尖端电子微导管测量左心室和升主动脉的有创压力波形。从主动脉压力波形计算固有频率(IF)参数。使用基于左心室压力的指数曲线拟合方法计算Tau。Tau范围为25.7 - 86.5毫秒(50.3±11),Tau = 48毫秒用作二元分类截止值。随机森林和K近邻分类器在44名患者上进行训练,并在10名患者上进行盲测。采用3折交叉验证以防止过拟合。
主要结果
我们提出的ML分类器模型使用基于物理学的特征准确预测真实的Tau类别,其中最准确的模型在预测盲数据上的真实Tau类别时,显示出80.0%(升高)和100.0%(正常)的成功率。
意义
我们证明了我们提出的基于物理学的ML模型可以使用单个主动脉压力波形的信息即时对Tau进行分类。尽管是侵入性验证,但所需的模型输入可以使用颈动脉波形非侵入性获取,朝着基于智能手机、患者激活的舒张功能障碍评估工具发展。