Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients
Background Left ventricular diastolic dysfunction (LVDD) predicts mortality in patients in cardiac intensive care units. An artificial intelligence enhanced ECG (AIECG) algorithm can predict LVDD and mortality in general populations but has not been examined in cardiac intensive care units. Methods...
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Wiley
2025-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037839 |
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| author | Jacob C. Jentzer Eunjung Lee Zachi Attia Dustin Hillerson Garvan C. Kane Francisco Lopez‐Jimenez Peter A. Noseworthy Paul A. Friedman Jae K. Oh |
| author_facet | Jacob C. Jentzer Eunjung Lee Zachi Attia Dustin Hillerson Garvan C. Kane Francisco Lopez‐Jimenez Peter A. Noseworthy Paul A. Friedman Jae K. Oh |
| author_sort | Jacob C. Jentzer |
| collection | DOAJ |
| description | Background Left ventricular diastolic dysfunction (LVDD) predicts mortality in patients in cardiac intensive care units. An artificial intelligence enhanced ECG (AIECG) algorithm can predict LVDD and mortality in general populations but has not been examined in cardiac intensive care units. Methods This historical cohort study included consecutive adults admitted to Mayo Clinic cardiac intensive care unit from 2007 to 2018 with an admission AIECG. The AIECG assigned the LVDD grade (0–3). Medial mitral E/e' ratio >15 on transthoracic echocardiogram (TTE) defined elevated filling pressures. In‐hospital and 1‐year mortality was evaluated, before and after multivariable adjustment. Results We included 11 868 patients (median age 69.5 years, 37.7% female); 48% had heart failure and 44% had acute coronary syndromes. AIECG LVDD grade was 0 (normal), 33%; 1, 7%; 2, 39%; and 3, 21%. In‐hospital and 1‐year mortality increased in each higher AIECG LVDD grade. After adjustment, each higher AIECG LVDD grade was associated with higher in‐hospital (adjusted odds ratio [OR], 1.22 [95% CI, 1.13–1.32]) and 1‐year mortality (adjusted hazard ratio [HR], 1.23 [95% CI, 1.19–1.29]); this persisted after adjustment for TTE measurements. Patients with grade 2 or 3 LVDD by AIECG and medial mitral E/e' ratio >15 by TTE had the highest in‐hospital (adjusted OR, 2.54 [95% CI, 1.69–3.88]) and 1‐year (adjusted HR, 2.03 [95% CI, 1.65–2.48]) mortality, whereas patients meeting either of these criteria had similar, elevated mortality. Conclusions The AIECG LVDD grade was strongly associated with in‐hospital and 1‐year mortality in patients in cardiac intensive care units, even after adjusting for clinical variables and TTE measurements. Patients with concordant AIECG and TTE for elevated filling pressures were at highest risk. |
| format | Article |
| id | doaj-art-b2d1b5cf97cb453d9bc8ac2a59d6476b |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-b2d1b5cf97cb453d9bc8ac2a59d6476b2025-08-20T03:13:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-03-0114510.1161/JAHA.124.037839Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit PatientsJacob C. Jentzer0Eunjung Lee1Zachi Attia2Dustin Hillerson3Garvan C. Kane4Francisco Lopez‐Jimenez5Peter A. Noseworthy6Paul A. Friedman7Jae K. Oh8Department of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USADepartment of Cardiovascular Medicine Mayo Clinic Rochester MN USABackground Left ventricular diastolic dysfunction (LVDD) predicts mortality in patients in cardiac intensive care units. An artificial intelligence enhanced ECG (AIECG) algorithm can predict LVDD and mortality in general populations but has not been examined in cardiac intensive care units. Methods This historical cohort study included consecutive adults admitted to Mayo Clinic cardiac intensive care unit from 2007 to 2018 with an admission AIECG. The AIECG assigned the LVDD grade (0–3). Medial mitral E/e' ratio >15 on transthoracic echocardiogram (TTE) defined elevated filling pressures. In‐hospital and 1‐year mortality was evaluated, before and after multivariable adjustment. Results We included 11 868 patients (median age 69.5 years, 37.7% female); 48% had heart failure and 44% had acute coronary syndromes. AIECG LVDD grade was 0 (normal), 33%; 1, 7%; 2, 39%; and 3, 21%. In‐hospital and 1‐year mortality increased in each higher AIECG LVDD grade. After adjustment, each higher AIECG LVDD grade was associated with higher in‐hospital (adjusted odds ratio [OR], 1.22 [95% CI, 1.13–1.32]) and 1‐year mortality (adjusted hazard ratio [HR], 1.23 [95% CI, 1.19–1.29]); this persisted after adjustment for TTE measurements. Patients with grade 2 or 3 LVDD by AIECG and medial mitral E/e' ratio >15 by TTE had the highest in‐hospital (adjusted OR, 2.54 [95% CI, 1.69–3.88]) and 1‐year (adjusted HR, 2.03 [95% CI, 1.65–2.48]) mortality, whereas patients meeting either of these criteria had similar, elevated mortality. Conclusions The AIECG LVDD grade was strongly associated with in‐hospital and 1‐year mortality in patients in cardiac intensive care units, even after adjusting for clinical variables and TTE measurements. Patients with concordant AIECG and TTE for elevated filling pressures were at highest risk.https://www.ahajournals.org/doi/10.1161/JAHA.124.037839artificial intelligencecoronary care unitdiastolic dysfunctionechocardiographyECG |
| spellingShingle | Jacob C. Jentzer Eunjung Lee Zachi Attia Dustin Hillerson Garvan C. Kane Francisco Lopez‐Jimenez Peter A. Noseworthy Paul A. Friedman Jae K. Oh Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease artificial intelligence coronary care unit diastolic dysfunction echocardiography ECG |
| title | Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients |
| title_full | Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients |
| title_fullStr | Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients |
| title_full_unstemmed | Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients |
| title_short | Artificial Intelligence ECG Diastolic Dysfunction and Survival in Cardiac Intensive Care Unit Patients |
| title_sort | artificial intelligence ecg diastolic dysfunction and survival in cardiac intensive care unit patients |
| topic | artificial intelligence coronary care unit diastolic dysfunction echocardiography ECG |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037839 |
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