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Journal of the American Heart Association.

Deep Learning–Based Algorithm for Detecting Aortic Stenosis Using Electrocardiography

  • Mar. 2020
  • by Joon‐Myoung Kwon et. al.

Background

Severe, symptomatic aortic stenosis (AS) is associated with poor prognoses. However, early detection of AS is difficult because of the long asymptomatic period experienced by many patients, during which screening tools are ineffective. The aim of this study was to develop and validate a deep learning–based algorithm, combining a multilayer perceptron and convolutional neural network, for detecting significant AS using ECGs.

 

Methods and Results

This retrospective cohort study included adult patients who had undergone both ECG and echocardiography. A deep learning–based algorithm was developed using 39 371 ECGs. Internal validation of the algorithm was performed with 6453 ECGs from one hospital, and external validation was performed with 10 865 ECGs from another hospital. The end point was significant AS (beyond moderate). We used demographic information, features, and 500Hz, 12lead ECG raw data as predictive variables. In addition, we identified which region had the most significant effect on the decisionmaking of the algorithm using a sensitivity map. During internal and external validation, the areas under the receiver operating characteristic curve of the deep learning–based algorithm using 12lead ECG for detecting significant AS were 0.884 (95% CI, 0.880–0.887) and 0.861 (95% CI, 0.858–0.863), respectively; those using a singlelead ECG signal were 0.845 (95% CI, 0.8410.848) and 0.821 (95% CI, 0.8160.825), respectively. The sensitivity map showed the algorithm focused on the T wave of the precordial lead to determine the presence of significant AS.

 

Conclusions

The deep learning–based algorithm demonstrated high accuracy for significant AS detection using both 12lead and singlelead ECGs.

Author

Joon‐Myoung Kwon, Soo Youn Lee , Ki‐Hyun Jeon, Yeha Lee, Kyung‐Hee Kim, Jinsik Park, Byung‐Hee Oh, and Myong‐Mook Lee

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