Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital Stethoscope
Background Despite the poor outcomes related to the presence of pulmonary hypertension, it often goes undiagnosed in part because of low suspicion and screening tools not being easily accessible such as echocardiography. A new readily available screening tool to identify elevated pulmonary artery sy...
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| Language: | English |
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Wiley
2025-02-01
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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.124.036882 |
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| author | Ling Guo Nivedita Khobragade Spencer Kieu Suleman Ilyas Preston N. Nicely Emmanuel K. Asiedu Fabio V. Lima Caroline Currie Emileigh Lastowski Gaurav Choudhary |
| author_facet | Ling Guo Nivedita Khobragade Spencer Kieu Suleman Ilyas Preston N. Nicely Emmanuel K. Asiedu Fabio V. Lima Caroline Currie Emileigh Lastowski Gaurav Choudhary |
| author_sort | Ling Guo |
| collection | DOAJ |
| description | Background Despite the poor outcomes related to the presence of pulmonary hypertension, it often goes undiagnosed in part because of low suspicion and screening tools not being easily accessible such as echocardiography. A new readily available screening tool to identify elevated pulmonary artery systolic pressures is needed to help with the prognosis and timely treatment of underlying causes such as heart failure or pulmonary vascular remodeling. We developed a deep learning–based method that uses phonocardiograms (PCGs) for the detection of elevated pulmonary artery systolic pressure, an indicator of pulmonary hypertension. Methods Approximately 6000 PCG recordings with the corresponding echocardiogram‐based estimated pulmonary artery systolic pressure values, as well as ≈169 000 PCG recordings without associated echocardiograms, were used for training a deep convolutional network to detect pulmonary artery systolic pressures ≥40 mm Hg in a semisupervised manner. Each 15‐second PCG, recorded using a digital stethoscope, was processed to generate 5‐second mel‐spectrograms. An additional labeled data set of 196 patients was used for testing. GradCAM++ was used to visualize high importance segments contributing to the network decision. Results An average area under the receiver operator characteristic curve of 0.79 was obtained across 5 cross‐validation folds. The testing data set gave a sensitivity of 0.71 and a specificity of 0.73, with pulmonic and left subclavicular locations having higher sensitivities. GradCAM++ technique highlighted physiologically meaningful PCG segments in example pulmonary hypertension recordings. Conclusions We demonstrated the feasibility of using digital stethoscopes in conjunction with deep learning algorithms as a low‐cost, noninvasive, and easily accessible screening tool for early detection of pulmonary hypertension. |
| format | Article |
| id | doaj-art-f7cdc8ac0d3f4af8bb444786bace1f2c |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-f7cdc8ac0d3f4af8bb444786bace1f2c2025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.124.036882Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital StethoscopeLing Guo0Nivedita Khobragade1Spencer Kieu2Suleman Ilyas3Preston N. Nicely4Emmanuel K. Asiedu5Fabio V. Lima6Caroline Currie7Emileigh Lastowski8Gaurav Choudhary9Eko Health Inc. Emeryville CA USAEko Health Inc. Emeryville CA USAEko Health Inc. Emeryville CA USAWarren Alpert Medical School Brown University Providence RI USAWarren Alpert Medical School Brown University Providence RI USAWarren Alpert Medical School Brown University Providence RI USAWarren Alpert Medical School Brown University Providence RI USAEko Health Inc. Emeryville CA USAEko Health Inc. Emeryville CA USAWarren Alpert Medical School Brown University Providence RI USABackground Despite the poor outcomes related to the presence of pulmonary hypertension, it often goes undiagnosed in part because of low suspicion and screening tools not being easily accessible such as echocardiography. A new readily available screening tool to identify elevated pulmonary artery systolic pressures is needed to help with the prognosis and timely treatment of underlying causes such as heart failure or pulmonary vascular remodeling. We developed a deep learning–based method that uses phonocardiograms (PCGs) for the detection of elevated pulmonary artery systolic pressure, an indicator of pulmonary hypertension. Methods Approximately 6000 PCG recordings with the corresponding echocardiogram‐based estimated pulmonary artery systolic pressure values, as well as ≈169 000 PCG recordings without associated echocardiograms, were used for training a deep convolutional network to detect pulmonary artery systolic pressures ≥40 mm Hg in a semisupervised manner. Each 15‐second PCG, recorded using a digital stethoscope, was processed to generate 5‐second mel‐spectrograms. An additional labeled data set of 196 patients was used for testing. GradCAM++ was used to visualize high importance segments contributing to the network decision. Results An average area under the receiver operator characteristic curve of 0.79 was obtained across 5 cross‐validation folds. The testing data set gave a sensitivity of 0.71 and a specificity of 0.73, with pulmonic and left subclavicular locations having higher sensitivities. GradCAM++ technique highlighted physiologically meaningful PCG segments in example pulmonary hypertension recordings. Conclusions We demonstrated the feasibility of using digital stethoscopes in conjunction with deep learning algorithms as a low‐cost, noninvasive, and easily accessible screening tool for early detection of pulmonary hypertension.https://www.ahajournals.org/doi/10.1161/JAHA.124.036882deep learningdigital stethoscopespulmonary hypertension |
| spellingShingle | Ling Guo Nivedita Khobragade Spencer Kieu Suleman Ilyas Preston N. Nicely Emmanuel K. Asiedu Fabio V. Lima Caroline Currie Emileigh Lastowski Gaurav Choudhary Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital Stethoscope Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease deep learning digital stethoscopes pulmonary hypertension |
| title | Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital Stethoscope |
| title_full | Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital Stethoscope |
| title_fullStr | Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital Stethoscope |
| title_full_unstemmed | Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital Stethoscope |
| title_short | Development and Evaluation of a Deep Learning–Based Pulmonary Hypertension Screening Algorithm Using a Digital Stethoscope |
| title_sort | development and evaluation of a deep learning based pulmonary hypertension screening algorithm using a digital stethoscope |
| topic | deep learning digital stethoscopes pulmonary hypertension |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.036882 |
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