Alabed, S. orcid.org/0000-0002-9960-7587, Uthoff, J., Zhou, S. et al. (15 more authors) (2022) Machine learning cardiac-MRI features predict mortality in newly diagnosed pulmonary arterial hypertension. European Heart Journal - Digital Health, 3 (2). pp. 265-275. ISSN 2634-3916
Abstract
Background
Pulmonary arterial hypertension (PAH) is a rare but serious disease associated with high mortality if left untreated. This study aims to assess the prognostic cardiac magnetic resonance (CMR) features in PAH using machine learning.
Methods
723 consecutive treatment-naive PAH patients were identified from the ASPIRE registry; 516 were included in the training and 207 in the validation cohort. A multilinear principal component analysis (MPCA) based machine learning approach was used to extract mortality and survival features throughout the cardiac cycle. The features were overlaid on the original imaging using thresholding and clustering of high- and low-risk of mortality prediction values.
Results
The one-year mortality rate in the validation cohort was 10%. Univariable Cox regression analysis of the combined short-axis and 4-chamber MPCA-based predictions was statistically significant (Hazard Ratios 2.1, 95% CI 1.3, 3.4, c-index = 0.70, p = .002). The MPCA features improved the one-year mortality prediction of REVEAL from c-index = 0.71 to 0.76 (p = < .001). Abnormalities in the end-systolic interventricular septum and end-diastolic left ventricle indicated the highest risk of mortality.
Conclusion
The MPCA-based machine learning is an explainable time-resolved approach that allows visualisation of prognostic cardiac features throughout the cardiac cycle at population level, making this approach transparent and clinically interpretable. In addition, the added prognostic value over the REVEAL risk score and CMR volumetric measurements allows for a more accurate prediction of one-year mortality risk in PAH.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Machine learning; Artificial Intelligence; Cardiac MRI; prognosis; mortality; Pulmonary hypertension |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 13 May 2022 10:15 |
Last Modified: | 23 Feb 2023 12:43 |
Status: | Published |
Publisher: | Oxford University Press |
Refereed: | Yes |
Identification Number: | 10.1093/ehjdh/ztac022 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:186801 |