Prediction of heart failure risk factors from retinal optical imaging via explainable machine learning

Over 64 million people worldwide are affected by heart failure (HF), a condition that significantly raises mortality and medical expenses. In this study, we explore the potential of retinal optical coherence tomography (OCT) features as non-invasive biomarkers for the classification of heart failure...

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Main Authors: Sona M. Al Younis, Samit Kumar Ghosh, Hina Raja, Feryal A. Alskafi, Siamak Yousefi, Ahsan H. Khandoker
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1551557/full
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author Sona M. Al Younis
Samit Kumar Ghosh
Hina Raja
Feryal A. Alskafi
Siamak Yousefi
Siamak Yousefi
Ahsan H. Khandoker
author_facet Sona M. Al Younis
Samit Kumar Ghosh
Hina Raja
Feryal A. Alskafi
Siamak Yousefi
Siamak Yousefi
Ahsan H. Khandoker
author_sort Sona M. Al Younis
collection DOAJ
description Over 64 million people worldwide are affected by heart failure (HF), a condition that significantly raises mortality and medical expenses. In this study, we explore the potential of retinal optical coherence tomography (OCT) features as non-invasive biomarkers for the classification of heart failure subtypes: left ventricular heart failure (LVHF), congestive heart failure (CHF), and unspecified heart failure (UHF). By analyzing retinal measurements from the left eye, right eye, and both eyes, we aim to investigate the relationship between ocular indicators and heart failure using machine learning (ML) techniques. We conducted nine classification experiments to compare normal individuals against LVHF, CHF, and UHF patients, using retinal OCT features from each eye separately and in combination. Our analysis revealed that retinal thickness metrics, particularly ISOS-RPE and macular thickness in various regions, were significantly reduced in heart failure patients. Logistic regression, CatBoost, and XGBoost models demonstrated robust performance, with notable accuracy and area under the curve (AUC) scores, especially in classifying CHF and UHF. Feature importance analysis highlighted key retinal parameters, such as inner segment-outer segment to retinal pigment epithelium (ISOS-RPE) and inner nuclear layer to the external limiting membrane (INL-ELM) thickness, as crucial indicators for heart failure detection. The integration of explainable artificial intelligence further enhanced model interpretability, shedding light on the biological mechanisms linking retinal changes to heart failure pathology. Our findings suggest that retinal OCT features, particularly when derived from both eyes, have significant potential as non-invasive tools for early detection and classification of heart failure. These insights may aid in developing wearable, portable diagnostic systems, providing scalable solutions for personalized healthcare, and improving clinical outcomes for heart failure patients.
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spelling doaj-art-c5aee134af8a4a10b8cffa70b793a14b2025-08-20T02:56:02ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15515571551557Prediction of heart failure risk factors from retinal optical imaging via explainable machine learningSona M. Al Younis0Samit Kumar Ghosh1Hina Raja2Feryal A. Alskafi3Siamak Yousefi4Siamak Yousefi5Ahsan H. Khandoker6Department of Biomedical Engineering and Biotechnology, Healthcare Engineering Innovation Group (HEIG), Khalifa University, Abu Dhabi, United Arab EmiratesDepartment of Biomedical Engineering and Biotechnology, Healthcare Engineering Innovation Group (HEIG), Khalifa University, Abu Dhabi, United Arab EmiratesDepartment of Mathematics and Computer Science, Fisk University, Nashville, TN, United StatesDepartment of Biomedical Engineering and Biotechnology, Healthcare Engineering Innovation Group (HEIG), Khalifa University, Abu Dhabi, United Arab EmiratesDepartment of Mathematics and Computer Science, Fisk University, Nashville, TN, United StatesDepartment of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, TN, United StatesDepartment of Biomedical Engineering and Biotechnology, Healthcare Engineering Innovation Group (HEIG), Khalifa University, Abu Dhabi, United Arab EmiratesOver 64 million people worldwide are affected by heart failure (HF), a condition that significantly raises mortality and medical expenses. In this study, we explore the potential of retinal optical coherence tomography (OCT) features as non-invasive biomarkers for the classification of heart failure subtypes: left ventricular heart failure (LVHF), congestive heart failure (CHF), and unspecified heart failure (UHF). By analyzing retinal measurements from the left eye, right eye, and both eyes, we aim to investigate the relationship between ocular indicators and heart failure using machine learning (ML) techniques. We conducted nine classification experiments to compare normal individuals against LVHF, CHF, and UHF patients, using retinal OCT features from each eye separately and in combination. Our analysis revealed that retinal thickness metrics, particularly ISOS-RPE and macular thickness in various regions, were significantly reduced in heart failure patients. Logistic regression, CatBoost, and XGBoost models demonstrated robust performance, with notable accuracy and area under the curve (AUC) scores, especially in classifying CHF and UHF. Feature importance analysis highlighted key retinal parameters, such as inner segment-outer segment to retinal pigment epithelium (ISOS-RPE) and inner nuclear layer to the external limiting membrane (INL-ELM) thickness, as crucial indicators for heart failure detection. The integration of explainable artificial intelligence further enhanced model interpretability, shedding light on the biological mechanisms linking retinal changes to heart failure pathology. Our findings suggest that retinal OCT features, particularly when derived from both eyes, have significant potential as non-invasive tools for early detection and classification of heart failure. These insights may aid in developing wearable, portable diagnostic systems, providing scalable solutions for personalized healthcare, and improving clinical outcomes for heart failure patients.https://www.frontiersin.org/articles/10.3389/fmed.2025.1551557/fullcardiovascular diseasesheart failuremachine learningdeep learningexplainable AIUK Biobank
spellingShingle Sona M. Al Younis
Samit Kumar Ghosh
Hina Raja
Feryal A. Alskafi
Siamak Yousefi
Siamak Yousefi
Ahsan H. Khandoker
Prediction of heart failure risk factors from retinal optical imaging via explainable machine learning
Frontiers in Medicine
cardiovascular diseases
heart failure
machine learning
deep learning
explainable AI
UK Biobank
title Prediction of heart failure risk factors from retinal optical imaging via explainable machine learning
title_full Prediction of heart failure risk factors from retinal optical imaging via explainable machine learning
title_fullStr Prediction of heart failure risk factors from retinal optical imaging via explainable machine learning
title_full_unstemmed Prediction of heart failure risk factors from retinal optical imaging via explainable machine learning
title_short Prediction of heart failure risk factors from retinal optical imaging via explainable machine learning
title_sort prediction of heart failure risk factors from retinal optical imaging via explainable machine learning
topic cardiovascular diseases
heart failure
machine learning
deep learning
explainable AI
UK Biobank
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1551557/full
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