Tensor-based multimodal learning for prediction of pulmonary arterial wedge pressure from cardiac MRI

Heart failure is a severe and life-threatening condition that can lead to elevated pressure in the left ventricle. Pulmonary Arterial Wedge Pressure (PAWP) is an important surrogate marker indicating high pressure in the left ventricle. PAWP is determined by Right Heart Catheterization (RHC) but it is an invasive procedure. A noninvasive method is useful in quickly identifying high-risk patients from a large population. In this work, we develop a tensor learning-based pipeline for identifying PAWP from multimodal cardiac Magnetic Resonance Imaging (MRI). This pipeline extracts spatial and temporal features from high-dimensional scans. For quality control, we incorporate an uncertainty-based binning strategy to identify poor-quality training samples. We leverage complementary information by integrating features from multimodal data: cardiac MRI with short-axis and four-chamber views, and cardiac measurements. The experimental analysis on a large cohort of 1346 subjects who underwent the RHC procedure for PAWP estimation indicates that the proposed pipeline has a diagnostic value and can produce promising performance with significant improvement over the baseline in clinical practice (i.e., ∆AUC = 0.10, ∆Accuracy = 0.06, and ∆MCC = 0.39). The decision curve analysis further confirms the clinical utility of our method. The source code can be found at: https://github.com/prasunc/PAW