npj Cardiovascular Health最新文献

{"title":"Acute Type A aortic dissection surgical repair in Octogenarians: A meta-analysis","authors":"Mohammed Tarek Hasan, Hazem Salah Rezq, Othman Saleh, Heba Aboeldahab, Mohammad K. El khashab, Salah Mahmoud Hamouda, Hassan Elkersh, Mohamed Ibrahim Gbreel, Aly Sherif Hassaballa, Ahmed K. Awad","doi":"10.1038/s44325-024-00007-9","DOIUrl":"10.1038/s44325-024-00007-9","url":null,"abstract":"Aortic dissection (AD), a life-threatening condition resulting from aortic wall tears, is especially concerning in the elderly. However, few studies have investigated long-term surgical outcomes in octogenarians with Type A aortic dissection (TAAD). Our paper addresses this critical knowledge gap. Four electronic databases were searched from inception till November 2022 to include any observational or randomized controlled trials (RCT) that evaluate long-term surgical outcomes of TAAD in octogenarians alone or compared with Septuagint focusing on factors including surgical approach, comorbidities, and preoperative status. The Mantel-Haenszel method was used to pool study estimates and calculate odds ratios (OR) with 95% confidence intervals (CI). We included 18,057 participants (10,253 males, 7804 females). In octogenarians and compared to medical treatment, surgical repair achieved significantly lower rates of re-exploration (9%), antegrade cerebral perfusion (33%), stroke (10%), and respiratory failure (19%). In terms of operative data, octogenarians had shorter cardiopulmonary bypass time (161.89 min), cross-clamp time (103.18 min), and myocardial ischemic time (90.89 min). Compared to septuagenarians, octogenarians had significantly shorter cardiopulmonary bypass and systemic cardiac arrest times (−13.84 min and −2.46 min, respectively). Additionally, octogenarians had a higher risk of respiratory complications (RR = 1.60). No significant differences were found for tracheostomy, antegrade cerebral perfusion, neurologic complications, and renal failure. In conclusion, octogenarians undergoing surgical repair for TAAD face relatively lower complication rates, but a higher risk of respiratory issues compared to septuagenarians, emphasizing the unique surgical challenges in this elderly fragile population.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00007-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using proteomics to identify the mechanisms underlying the benefits of statins on ischemic heart disease","authors":"Jie V. Zhao, Junmeng Zhang","doi":"10.1038/s44325-024-00018-6","DOIUrl":"10.1038/s44325-024-00018-6","url":null,"abstract":"Ischemic heart disease (IHD) is the single leading cause of mortality globally. Statins are the mainstay for IHD treatment. However, the specific mechanisms underlying statins’ benefits on IHD have not been clarified. To examine the mechanisms through proteins, we used two-step Mendelian randomization (MR) approach. First, we examined the associations of genetically mimicked statins with 2923 proteins using genome-wide association of proteins from the UK Biobank Pharma Proteomics Project (UKB-PPP) to identify the proteins affected by statins, and replicated the findings using deCODE. Then we examined the associations of selected proteins with IHD risk using CARDIoGRAMplusC4D using MR, and replicated using FinnGen, and using another set of genetic instruments from deCODE. We selected proteins decreased or increased IHD risk and meanwhile increased or lowered by statins. We further examined the role of the selected protein(s) on common IHD comorbidities, including diabetes, chronic kidney disease (CKD), and kidney function (measured by estimated glomerular filtration rate (eGFR)). Nine proteins were affected by statins, including four proteins (PLA2G7, FGFBP1, ANGPTL1, and PTPRZ1) lowered by statins, and five proteins (EFNA4, COL6A3, ASGR1, PRSS8 and PCOLCE) increased by statins. Among these, PLA2G7 was related to higher risk of IHD after controlling for multiple testing. The associations were robust to different analytic methods and replication using another set of genetic instrument from deCODE, and using another GWAS of IHD from FinnGen. Genetically predicted PLA2G7 had null association with diabetes, CKD, and eGFR. We identified 9 proteins affected by statins, including 7 novel proteins which were not reported previously. PLA2G7 is on the pathway underlying statins’ benefits on IHD. The clarification of statins’ mechanisms had close relevance to precision medicine, and provided insights to the development of new treatment strategies.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00018-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular ICG-enhanced NIRF-IVUS imaging to assess progressive atherosclerotic lesions in excised human coronary arteries","authors":"Philipp Rauschendorfer, Tobias Lenz, Philipp Nicol, Léa Wild, Alicia Beele, Emina Sabic, Grace Klosterman, Karl-Ludwig Laugwitz, Farouc A. Jaffer, Dimitris Gorpas, Michael Joner, Vasilis Ntziachristos","doi":"10.1038/s44325-024-00016-8","DOIUrl":"10.1038/s44325-024-00016-8","url":null,"abstract":"Indocyanine green (ICG)-enhanced intravascular near-infrared fluorescence (NIRF) imaging enhances the information obtained with intravascular ultrasound (IVUS) by visualizing pathobiological characteristics of atherosclerotic plaques. To advance our understanding of this hybrid method, we aimed to assess the potential of NIRF-IVUS to identify different stages of atheroma progression by characterizing ICG uptake in human pathological specimens. After excision, 15 human coronary specimens from 13 adult patients were ICG-perfused and imaged with NIRF-IVUS. All specimens were then histopathologically and immunohistochemically assessed. NIRF-IVUS imaging revealed colocalization of ICG-deposition to plaque areas of lipid accumulation, endothelial disruption, neovascularization and inflammation. Moreover, ICG concentrations were significantly higher in advanced coronary artery disease stages (p < 0.05) and correlated significantly to plaque macrophage burden (r = 0.67). Current intravascular methods fail to detect plaque biology. Thus, we demonstrate how human coronary atheroma stage can be assessed based on pathobiological characteristics uniquely captured by ICG-enhanced intravascular NIRF.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00016-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic association of serum calcium, phosphate, vitamin D, parathyroid hormone, and FGF23 with the risk of aortic stenosis","authors":"Qinghao Zhao, Wenchang Nie, Jiaming Dong, Bowen Zhang, Gongzheng Tang, Shenda Hong, Jian Liu","doi":"10.1038/s44325-024-00013-x","DOIUrl":"10.1038/s44325-024-00013-x","url":null,"abstract":"Disorders of mineral metabolism, including elevated levels of serum calcium, phosphate, 25-hydroxyvitamin D (25OH-VitD), parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF23), have been reported in patients with calcific aortic valve stenosis (CAVS). However, evidence of the causal role of mineral metabolism in CAVS is still lacking. In this study, we employed a systematic pipeline combining Mendelian randomization (MR), Steiger directionality test, colocalization analysis, protein-protein network, and enrichment analysis to investigate the causal effect of mineral metabolism on CAVS. Genome-wide association study (GWAS) and protein quantitative trait loci data for mineral metabolism markers were extracted from large-scale meta-analyses. Summary statistics for CAVS were obtained from two independent GWAS datasets as discovery and replication cohorts (n = 374,277 and 653,867). In MR analysis, genetic mimicry of serum FGF23 elevation was associated with increased CAVS risk [ORdiscovery = 3.081 (1.649–5.760), Pdiscovery = 4.21 × 10−4; ORreplication = 2.280 (1.461 – 3.558), Preplication = 2.82 × 10−4] without evidence of reverse causation (Psteiger= 7.21 × 10−98). Strong colocalisation association with CAVS was observed for FGF23 expression in the blood (PP.H4 = 0.96). Additionally, we identified some protein-protein interactions between FGF23 and known CAVS-associated genes. Serum calcium, phosphate, 25OH-VitD, and PTH failed to show causal effects on CAVS at Bonferroni-corrected significance (all P > 0.05/5 = 0.01). In conclusion, elevated serum FGF23 level may act as a causal risk factor for CAVS, and its mechanism of action in CAVS development may be independent of its function in regulating mineral metabolism. Hence, FGF23 may serve as a circulating marker and a promising preventive target for CAVS, warranting further investigation.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00013-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142013697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A translational framework of genoproteomic studies for cardiovascular drug discovery","authors":"Zhao Yang, Jie V. Zhao, Yue Qi, Xuan Deng, Zhili Ji, Jing Liu","doi":"10.1038/s44325-024-00015-9","DOIUrl":"10.1038/s44325-024-00015-9","url":null,"abstract":"Cardiovascular drug development has faced significant challenges in recent decades. The emergence of population-scale genome- and proteome-wide data, alongside sophisticated genetic analytical tools like Mendelian randomization and pragmatic target trials, presents an unprecedented chance to identify and validate drug-targeting proteins for cardiovascular disease. However, how to translate these advances into clinical applications remains to be discovered. This study proposes and validates a translational framework that leverages emerging genoproteomic data and cutting-edge causal analysis techniques to address the intricate benefit-risk concerns associated with cardiovascular drug development. Specifically, the framework elucidates underlying biological mechanisms, identifies and validates potential drug-targeting proteins, and explores the unintended side effects, complementary with pragmatic target trials. Moreover, we illustrate the translational framework via a step-by-step example alongside practical implementation recommendations for cardiovascular drug discovery. We envision this translational framework as a starting point in advancing multi-omics studies, thereby accelerating cardiovascular drug development.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00015-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for long-term cardiovascular post-acute sequelae of COVID-19 infection: A nested case-control study in Hong Kong","authors":"Qiuyan Yu, Min Fan, Celia Jiaxi Lin, David Tak Wai Lui, Kathryn Choon Beng Tan, Kai Hang Yiu, Ralph Kwame Akyea, Nadeem Qureshi, Francisco Tsz Tsun Lai, Eric Yuk Fai Wan, Xue Li, Esther Wai Yin Chan, Ian Chi Kei Wong, Celine Sze Ling Chui","doi":"10.1038/s44325-024-00011-z","DOIUrl":"10.1038/s44325-024-00011-z","url":null,"abstract":"People with COVID-19 can experience post-acute sequelae of SARS-CoV-2 (PASC). Studies on risk factors of PASC outcomes are ongoing, especially for endocrine system-related diseases that may impact the cardiovascular system. Cardiac-related PASC is one of the burdens after COVID-19 infection. This study aimed to examine the risk factors of cardiac-related PASC. In this nested case-control study, we obtained electronic health records (EHRs) database from the Hong Kong Hospital Authority. We defined cases as patients with at least one cardiac-related PASC and controls as patients without any cardiac-related PASC. We applied the incidence density sampling and matched controls to cases on age and sex at a 1:10 ratio. Multivariable conditional logistic regression was used to determine the associations between risk factors and cardiac-related PASC. A total of 455 individuals with cardiac-related PASC and matched 3,423 controls were obtained in the underlying cohort. COVID-19-associated hospitalisation (aOR: 1.41, 95% CI: 1.03–1.93) and peripheral vascular disease (aOR: 2.98, 95% CI: 1.31–6.79) were associated with an increased likelihood of cardiac-related PASC. Higher doses of the COVID-19 vaccine (2 doses: 0.68 [0.52–0.89]; ≥3 doses: 0.56 [0.40–0.78]) and more frequent healthcare utilization visits (aOR: 0.95, 95% CI: 0.92–0.97) were associated with a lower likelihood of cardiac-related PASC. This is the first study to examine risk factors of cardiac-related PASC among the Chinese population. We identified peripheral vascular disease and COVID-19-associated hospitalisation as the risk factors for cardiac-related PASC. COVID-19 vaccination was protective against cardiac-related PASC, which should be prioritized for high-risk patients.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00011-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atherosclerotic cardiovascular disease in aging and the role of advanced cardiovascular imaging","authors":"Jie Jun Wong, Rilong Hong, Louis L. Y. Teo, Ru-San Tan, Angela S. Koh","doi":"10.1038/s44325-024-00012-y","DOIUrl":"10.1038/s44325-024-00012-y","url":null,"abstract":"Aging and inflammation are key drivers in the pathogenesis of cardiovascular disease. Aging is characterized by chronic, systemic, dysregulated inflammation and dysfunctional immune responses ― termed inflammaging ― that give rise to cumulative cardiovascular damage. These noxious processes promote epithelial dysfunction, immune infiltration, foam cell deposition, and calcification, which result in atherosclerotic plaque formation. With aging, epithelial and vascular smooth muscle cell senescence further contribute to atherogenesis by the acquisition of the senescence-associated secretory phenotype, consequently secreting pro-inflammatory and pro-fibrotic factors that exert autocrine and paracrine effects to perpetuate a vicious cycle of tissue aging and eventual failure. Recent evidence has affirmed the use of anti-inflammatory therapy to reduce cardiovascular risk; however, the possibility of off-target adverse effects may limit the application. Moreover, systemic inflammatory markers are not sufficiently precise in localizing cardiovascular active inflammation, and conventional cardiovascular imaging methods can only detect structural changes in late-stage disease. Targeted molecular imaging offers imaging-guided precision theragnostic and early upstream preventive approaches by delineating the cellular biological mechanisms underpinning cardiovascular inflammaging and holds the potential to revolutionize the personalized treatment of early atherosclerotic disease. Here, we examine recent developments in molecular imaging in relation to the mechanisms underlying aging-related atherosclerotic cardiovascular disease. We highlight challenges facing the translation of molecular imaging into clinical practice and propose future directions of these novel diagnostic modalities.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00012-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and physical inactivity are associated with increased risks of cardiac conduction disease: a report from the Kailuan Cohort Study","authors":"Hongmin Liu, Xinmu Li, Peipei Liu, Haiyan Zhao, Liming Lin, Gary Tse, Jeffrey Shi Kai Chan, Gregory Y. H. Lip, Shouling Wu, Tong Liu","doi":"10.1038/s44325-024-00008-8","DOIUrl":"10.1038/s44325-024-00008-8","url":null,"abstract":"Physical activity (PA) and obesity may alter the risks of cardiac conduction disease. Participants from the Kailuan cohort, who were free of cardiac conduction disease and with repeated measurements of electrocardiogram from 2006 to 2019, were included. The primary outcome was cardiac conduction disease. The secondary outcomes were atrioventricular block and intraventricular block. Cox regression was used to assess the association between obesity, PA, and the risks of the outcomes. Influences of PA on the associations between BMI and incident outcomes were evaluated. A total of 84,022 participants (mean age 50.15 years, SD 11.69; 80.3% male) were included. Over a median follow-up of 11.83 years (IQR 8.87–13.04), 3236 participants developed the primary outcome. After multivariable adjustment, a higher body mass index (BMI) and a higher waist circumference (WC) were associated with increased risks of conduction disease, but more PA was associated with a lower risk. For obese patients defined by BMI with low PA, the risk of conduction disease was higher than that of obese patients with high PA (HR: 1.42, CI: 1.21-1.66 vs. HR: 1.16, CI: 1.03–1.31). For central obese patients defined by WC with low PA, the risk of conduction disease was also higher compared to central obese patients with high PA (HR: 1.31, CI: 1.17–1.48 vs. HR: 1.12, CI: 1.03–1.23). Besides, compared to obesity with high PA, obesity with low PA was associated with a higher risk of atrioventricular block (HR: 1.70, CI: 1.28-2.27 vs. HR: 1.45, CI: 1.16-1.81) and intraventricular block (HR: 1.37, CI: 1.13-1.65 vs. HR: 1.03, CI: 0.92–1.15). Higher PA can reduce the risks of developing cardiac conduction disease, both in the obese and non-obese groups. (Clinical Trial Registration URL: https://www.chictr.org . Unique identifier: ChiCTRTNC-11001489).","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00008-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141806324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and prevention of in-hospital cardiac arrest: present and future","authors":"Jonathan Vo, Faye L. Norby, Paul Marano, Yuri Matusov, Kyndaron Reinier, Joseph Ebinger, Henry Halperin, Sumeet S. Chugh","doi":"10.1038/s44325-024-00009-7","DOIUrl":"10.1038/s44325-024-00009-7","url":null,"abstract":"Cardiac arrest is most commonly defined as the cessation of cardiac mechanical activity requiring either delivery of chest compressions and/or defibrillation. The condition is often subdivided into in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) based on different locations, but also differences in epidemiology, natural history, co-morbidities, process of care, and provider characteristics. Both are complex conditions that warrant ongoing research to improve management, but IHCA appears to have received disproportionately less investigative attention. Recent reviews of over 150 randomized controlled trials (RCTs) conducted between 1995 and 2019 reported that the vast majority (>80%) were focused on OHCA, approximately 10% on both and <10% were focused solely on IHCA. In this review, we will provide an overview of current knowledge regarding IHCA epidemiology, management and prevention, while also identifying opportunities for future research.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00009-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-expert ensemble ECG diagnostic algorithm using mutually exclusive–symbiotic correlation between 254 hierarchical multiple labels","authors":"Jiewei Lai, Yue Zhang, Chenyu Zhao, Jinliang Wang, Yong Yan, Mingyang Chen, Lei Ji, Jun Guo, Baoshi Han, Yajun Shi, Jinxia Zhang, Yundai Chen, Qianjin Feng, Wei Yang","doi":"10.1038/s44325-024-00010-0","DOIUrl":"10.1038/s44325-024-00010-0","url":null,"abstract":"Electrocardiograms (ECGs) are a cheap and convenient means of assessing heart health and provide an important basis for diagnosis and treatment by cardiologists. However, existing intelligent ECG diagnostic approaches can only detect up to several tens of ECG terms, which barely cover the most common arrhythmias. Thus, further diagnosis is required by cardiologists in clinical settings. This paper describes the development of a multi-expert ensemble learning model that can recognize 254 ECG terms. Based on data from 191,804 wearable 12-lead ECGs, mutually exclusive–symbiotic correlations between hierarchical multiple labels are applied at the loss level to improve the diagnostic performance of the model and make its predictions more reasonable while alleviating the difficulty of class imbalance. The model achieves an average area under the receiver operating characteristics curve of 0.973 and 0.956 on offline and online test sets, respectively. We select 130 terms from the 254 available for clinical settings by considering the classification performance and clinical significance, providing real-time and comprehensive ancillary support for the public.","PeriodicalId":501706,"journal":{"name":"npj Cardiovascular Health","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44325-024-00010-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141500513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}