Deep learning-based prognostic model using non-enhanced cardiac cine MRI for outcome prediction in patients with heart failure.

OBJECTIVES: To evaluate the performance of a deep learning-based multi-source model for survival prediction and risk stratification in patients with heart failure. METHODS: Patients with heart failure with reduced ejection fraction (HFrEF) who underwent cardiac magnetic resonance between January 2015 and April 2020 were retrospectively included in this study. Baseline electronic health record data, including clinical demographic information, laboratory data, and electrocardiographic information, were collected. Short-axis non-contrast cine images of the whole heart were acquired to estimate the cardiac function parameters and the motion features of the left ventricle. Model accuracy was evaluated using the Harrell's concordance index. All patients were followed up for major adverse cardiac events (MACEs), and survival prediction was assessed using Kaplan-Meier curves. RESULTS: A total of 329 patients were evaluated (age 54 ± 14 years; men, 254) in this study. During a median follow-up period of 1041 days, 62 patients experienced MACEs and their median survival time was 495 days. When compared with conventional Cox hazard prediction models, deep learning models showed better survival prediction performance. Multi-data denoising autoencoder (DAE) model reached the concordance index of 0.8546 (95% CI: 0.7902-0.8883). Furthermore, when divided into phenogroups, the multi-data DAE model could significantly discriminate between the survival outcomes of the high-risk and low-risk groups compared with other models (p < 0.001). CONCLUSIONS: The proposed deep learning (DL) model based on non-contrast cardiac cine magnetic resonance imaging could independently predict the outcome of patients with HFrEF and showed better prediction efficiency than conventional methods. CLINICAL RELEVANCE STATEMENT: The proposed multi-source deep learning model based on cardiac magnetic resonance enables survival prediction in patients with heart failure. KEY POINTS: • A multi-source deep learning model based on non-contrast cardiovascular magnetic resonance (CMR) cine images was built to make robust survival prediction in patients with heart failure. • The ground truth definition contains electronic health record data as well as DL-based motion data, and cardiac motion information is extracted by optical flow method from non-contrast CMR cine images. • The DL-based model exhibits better prognostic value and stratification performance when compared with conventional prediction models and could aid in the risk stratification in patients with HF.

Survival prediction of heart failure patients using motion-based analysis method.

BACKGROUND AND OBJECTIVE: Survival prediction of heart failure patients is critical to improve the prognostic management of the cardiovascular disease. The existing survival prediction methods focus on the clinical information while lacking the cardiac motion information. we propose a motion-based analysis method to predict the survival risk of heart failure patients for aiding clinical diagnosis and treatment. METHODS: We propose a motion-based analysis method for survival prediction of heart failure patients. First, our method proposes the hierarchical spatial-temporal structure to capture the myocardial border. It promotes the model discrimination on border features. Second, our method explores the dense optical flow structure to capture motion fields. It improves the tracking capability on cardiac images. The cardiac motion information is obtained by fusing boundary information and motion fields of cardiac images. Finally, our method proposes the multi-modality deep-cox structure to predict the survival risk of heart failure patients. It improves the survival probability of heart failure patients. RESULTS: The motion-based analysis method is confirmed to be able to improve the survival prediction of heart failure patients. The precision, recall, F1-score, and C-index are 0.8519, 0.8333, 0.8425, and 0.8478, respectively, which is superior to other state-of-the-art methods. CONCLUSIONS: The experimental results show that the proposed model can effectively predict survival risk of heart failure patients. It facilitates the application of robust clinical treatment strategies.

Multi-level semantic adaptation for few-shot segmentation on cardiac image sequences.

Obtaining manual labels is time-consuming and labor-intensive on cardiac image sequences. Few-shot segmentation can utilize limited labels to learn new tasks. However, it suffers from two challenges: spatial-temporal distribution bias and long-term information bias. These challenges derive from the impact of the time dimension on cardiac image sequences, resulting in serious over-adaptation. In this paper, we propose the multi-level semantic adaptation (MSA) for few-shot segmentation on cardiac image sequences. The MSA addresses the two biases by exploring the domain adaptation and the weight adaptation on the semantic features in multiple levels, including sequence-level, frame-level, and pixel-level. First, the MSA proposes the dual-level feature adjustment for domain adaptation in spatial and temporal directions. This adjustment explicitly aligns the frame-level feature and the sequence-level feature to improve the model adaptation on diverse modalities. Second, the MSA explores the hierarchical attention metric for weight adaptation in the frame-level feature and the pixel-level feature. This metric focuses on the similar frame and the target region to promote the model discrimination on the border features. The extensive experiments demonstrate that our MSA is effective in few-shot segmentation on cardiac image sequences with three modalities, i.e. MR, CT, and Echo (e.g. the average Dice is 0.9243), as well as superior to the ten state-of-the-art methods.

A Multi-Task Group Bi-LSTM Networks Application on Electrocardiogram Classification.

BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of death globally. Electrocardiogram (ECG) analysis can provide thoroughly assessment for different CVDs efficiently. We propose a multi-task group bidirectional long short-term memory (MTGBi-LSTM) framework to intelligent recognize multiple CVDs based on multi-lead ECG signals. METHODS: This model employs a Group Bi-LSTM (GBi-LSTM) and Residual Group Convolutional Neural Network (Res-GCNN) to learn the dual feature representation of ECG space and time series. GBi-LSTM is divided into Global Bi-LSTM and Intra-Group Bi-LSTM, which can learn the features of each ECG lead and the relationship between leads. Then, through attention mechanism, the different lead information of ECG is integrated to make the model to possess the powerful feature discriminability. Through multi-task learning, the model can fully mine the association information between diseases and obtain more accurate diagnostic results. In addition, we propose a dynamic weighted loss function to better quantify the loss to overcome the imbalance between classes. RESULTS: Based on more than 170,000 clinical 12-lead ECG analysis, the MTGBi-LSTM method achieved accuracy, precision, recall and F1 of 88.86%, 90.67%, 94.19% and 92.39%, respectively. The experimental results show that the proposed MTGBi-LSTM method can reliably realize ECG analysis and provide an effective tool for computer-aided diagnosis of CVD.

Research on Improved Depth Belief Network-Based Prediction of Cardiovascular Diseases.

Quantitative analysis and prediction can help to reduce the risk of cardiovascular disease. Quantitative prediction based on traditional model has low accuracy. The variance of model prediction based on shallow neural network is larger. In this paper, cardiovascular disease prediction model based on improved deep belief network (DBN) is proposed. Using the reconstruction error, the network depth is determined independently, and unsupervised training and supervised optimization are combined. It ensures the accuracy of model prediction while guaranteeing stability. Thirty experiments were performed independently on the Statlog (Heart) and Heart Disease Database data sets in the UCI database. Experimental results showed that the mean of prediction accuracy was 91.26% and 89.78%, respectively. The variance of prediction accuracy was 5.78 and 4.46, respectively.