{"title":"Leveraging ECG Images for Predicting Ejection Fraction using Machine Learning Algorithms.","authors":"Abhyuday Kumara Swamy, Vivek Rajagopal, Deepak Krishnan, Paramita Auddya Ghorai, Anagha Choukhande, Santhosh Rathnam Palani, Deepak Padmanabhan, Emmanuel Rupert, Devi Prasad Shetty, Pradeep Narayan","doi":"10.1016/j.ihj.2025.03.009","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The capability to accurately predict the ejection fraction (EF) from an electrocardiogram (ECG) holds significant and valuable clinical implications. Various algorithms based on ECG images are currently being evaluated, with most methods requiring raw signal data from ECG devices. In this study, our objective was to train and validate a neural network on a readily available ECG trace image graph to determine the presence or absence of left ventricular dysfunction (LVD).</p><p><strong>Methods: </strong>12-lead ECG trace images paired with their echocardiogram reports performed on the same day were selected. A DenseNet121 model, using ECG images as input, was trained to identify EF <50%. and then externally validated.</p><p><strong>Results: </strong>1,19,281 ECG-echocardiogram pairs were used for model development. The model demonstrated comparable performance in both the internal test data and external validation data. The area under receiver operating characteristic and precision-recall curves were 0.92 and 0.78, respectively, for the internal test data and 0.88 and 0.74, respectively, for the external validation data. The model accurately identified more than 85% of cases with EF <50% in both datasets.</p><p><strong>Conclusions: </strong>Actual images of ECGs with simple pre-processing and model architecture can be used as a reliable tool to screen for LVD. The use of images expands the reach of these algorithms to geographies with resource and technological limitations.</p>","PeriodicalId":13384,"journal":{"name":"Indian heart journal","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian heart journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.ihj.2025.03.009","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The capability to accurately predict the ejection fraction (EF) from an electrocardiogram (ECG) holds significant and valuable clinical implications. Various algorithms based on ECG images are currently being evaluated, with most methods requiring raw signal data from ECG devices. In this study, our objective was to train and validate a neural network on a readily available ECG trace image graph to determine the presence or absence of left ventricular dysfunction (LVD).
Methods: 12-lead ECG trace images paired with their echocardiogram reports performed on the same day were selected. A DenseNet121 model, using ECG images as input, was trained to identify EF <50%. and then externally validated.
Results: 1,19,281 ECG-echocardiogram pairs were used for model development. The model demonstrated comparable performance in both the internal test data and external validation data. The area under receiver operating characteristic and precision-recall curves were 0.92 and 0.78, respectively, for the internal test data and 0.88 and 0.74, respectively, for the external validation data. The model accurately identified more than 85% of cases with EF <50% in both datasets.
Conclusions: Actual images of ECGs with simple pre-processing and model architecture can be used as a reliable tool to screen for LVD. The use of images expands the reach of these algorithms to geographies with resource and technological limitations.
期刊介绍:
Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.