Artificial Intelligence Tools for Preconception Cardiomyopathy Screening Among Women of Reproductive Age.

Abstract

Purpose: Identifying cardiovascular disease before conception and in early pregnancy can better inform obstetric cardiovascular care. Our main objective was to evaluate the diagnostic performance of artificial intelligence (AI)-enabled digital tools for detecting left ventricular systolic dysfunction (LVSD) among women of reproductive age.

Methods: In a pilot cross-sectional study, we enrolled an initial cohort of 100 consecutive women aged 18-49 years who had a primary care physician and a scheduled echocardiography at Mayo Clinic Florida (Jacksonville) (cohort 1). Twelve-lead electrocardiography (ECG) and digital stethoscope recordings (single-lead ECG + phonocardiography) were performed on the date of echocardiography. We used deep learning to generate prediction probabilities for LVSD (defined as left ventricular ejection fraction <50%) for the 12-lead ECG (AI-ECG) and stethoscope (AI-stethoscope) recordings. In a second cohort of 100 participants, we enrolled consecutive women seen in primary care to estimate the prevalence of positive AI screening results when deployed for routine use (cohort 2).

Results: The median age of participants was 38.6 years (quartile 1: 30.3 years, quartile 3: 45.5 years), and 71.9% identified as part of the non-Hispanic White population. Among cohort 1, 5% had LVSD. The AI-ECG had an area under the curve of 0.94, and the AI-stethoscope (maximum prediction across all chest locations) had an area under the curve of 0.98. Among cohort 2, the prevalence of a positive AI screen was 1% and 3.2% for AI-ECG and the AI-stethoscope, respectively.

Conclusion: We found these AI tools to be effective for the detection of cardiomyopathy associated with LVSD among women of reproductive age. These tools could potentially be useful for preconception cardiovascular evaluations.