Genetic underpinnings of predicted changes in cardiovascular function using self supervised learning

Background The genetic underpinnings of cardiovascular disease remain elusive. Contrastive learning algorithms have recently shown cutting-edge performance in extracting representations from electrocardiogram (ECG) signals that characterize cross-temporal cardiovascular state. However, there is currently no connection between these representations and genetics. Methods We designed a new metric, denoted as Delta ECG, which measures temporal shifts in patients' cardiovascular state, and inherently adjusts for inter-patient differences at baseline. We extracted this measure for 4,782 patients in the Human Phenotype Project using a novel self-supervised learning model, and quantified the associated genetic signals with Genome-Wide-Association Studies (GWAS). We predicted the expression of thousands of genes extracted from Peripheral Blood Mononuclear Cells (PBMCs). Downstream, we ran enrichment and overrepresentation analysis of genes we identified as significantly predicted from ECG. Findings In a Genome-Wide Association Study (GWAS) of Delta ECG, we identified five associations that achieved genome-wide significance. From baseline embeddings, our models significantly predict the expression of 57 genes in men and 9 in women. Enrichment analysis showed that these genes were predominantly associated with the electron transport chain and the same immune pathways as identified in our GWAS. Conclusions We validate a novel method integrating self-supervised learning in the medical domain and simple linear models in genetics. Our results indicate that the processes underlying temporal changes in cardiovascular health share a genetic basis with CVD, its major risk factors, and its known correlates. Moreover, our functional analysis confirms the importance of leukocytes, specifically eosinophils and mast cells with respect to cardiac structure and function.