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Yu S, Han S, Shi M, Harada M, Ge J, Li X, Cai X, Heier M, Karstenmüller G, Suhre K, Gieger C, Koenig W, Rathmann W, Peters A, Wang-Sattler R. Prediction of Myocardial Infarction Using a Combined Generative Adversarial Network Model and Feature-Enhanced Loss Function. Metabolites 2024; 14:258. [PMID: 38786735 PMCID: PMC11122941 DOI: 10.3390/metabo14050258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Accurate risk prediction for myocardial infarction (MI) is crucial for preventive strategies, given its significant impact on global mortality and morbidity. Here, we propose a novel deep-learning approach to enhance the prediction of incident MI cases by incorporating metabolomics alongside clinical risk factors. We utilized data from the KORA cohort, including the baseline S4 and follow-up F4 studies, consisting of 1454 participants without prior history of MI. The dataset comprised 19 clinical variables and 363 metabolites. Due to the imbalanced nature of the dataset (78 observed MI cases and 1376 non-MI individuals), we employed a generative adversarial network (GAN) model to generate new incident cases, augmenting the dataset and improving feature representation. To predict MI, we further utilized multi-layer perceptron (MLP) models in conjunction with the synthetic minority oversampling technique (SMOTE) and edited nearest neighbor (ENN) methods to address overfitting and underfitting issues, particularly when dealing with imbalanced datasets. To enhance prediction accuracy, we propose a novel GAN for feature-enhanced (GFE) loss function. The GFE loss function resulted in an approximate 2% improvement in prediction accuracy, yielding a final accuracy of 70%. Furthermore, we evaluated the contribution of each clinical variable and metabolite to the predictive model and identified the 10 most significant variables, including glucose tolerance, sex, and physical activity. This is the first study to construct a deep-learning approach for producing 7-year MI predictions using the newly proposed loss function. Our findings demonstrate the promising potential of our technique in identifying novel biomarkers for MI prediction.
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Affiliation(s)
- Shixiang Yu
- TUM School of Medicine and Health, Technical University of Munich, 81675 München, Germany; (S.Y.); (S.H.); (M.S.); (J.G.)
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Siyu Han
- TUM School of Medicine and Health, Technical University of Munich, 81675 München, Germany; (S.Y.); (S.H.); (M.S.); (J.G.)
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Mengya Shi
- TUM School of Medicine and Health, Technical University of Munich, 81675 München, Germany; (S.Y.); (S.H.); (M.S.); (J.G.)
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Makoto Harada
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Jianhong Ge
- TUM School of Medicine and Health, Technical University of Munich, 81675 München, Germany; (S.Y.); (S.H.); (M.S.); (J.G.)
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Xuening Li
- Biocomputing R&D Department, Beijing Huanyang Bole Consulting Co., Ltd., Beijing 100010, China;
| | - Xiang Cai
- School of Computer Science and Information Security, Guilin University of Electronic Technology, Guilin 541214, China;
| | - Margit Heier
- KORA Study Centre, University Hospital of Augsburg, 86153 Augsburg, Germany;
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Gabi Karstenmüller
- Institute of Computational Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Karsten Suhre
- Department of Physiology and Biophysics, Weill Cornell Medicine and Director of the Bioinformatics Core, Doha 24144, Qatar;
| | - Christian Gieger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, 80636 München, Germany;
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, 40225 Düsseldorf, Germany;
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Pettenkofer School of Public Health, Faculty of Medicine, Ludwig-Maximilians-Universität München, 81377 München, Germany
| | - Rui Wang-Sattler
- Institute of Translational Genomics, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
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Jha CK. Automated cardiac arrhythmia detection techniques: a comprehensive review for prospective approach. Comput Methods Biomech Biomed Engin 2024:1-16. [PMID: 38566498 DOI: 10.1080/10255842.2024.2332942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Abnormal cardiac functionality produces irregular heart rhythms which are commonly known as arrhythmias. In some conditions, arrhythmias are treated as very dangerous which may lead to sudden cardiac arrest. The incidence and prevalence of cardiac anomalies seeks early detection of arrhythmias using automated classification techniques. In the past, numerous automated arrhythmia detection techniques have been developed that are based on electrocardiogram (ECG) signal analysis. Focusing on the prospective research in this field, this article reports a comprehensive review of existing techniques that are obtained using search engines such as IEEE explore, Google scholar and science direct. Based on the review, the existing techniques are broadly categorized into two types: machine-learning and deep-learning-based techniques. In this study, it is noticed that the performance of the machine-learning-based arrhythmia detection techniques depend on pre-processing of ECG signal, R-peaks detection, features extraction and classification tools while the deep-learning-based techniques do not require the features extraction step. Generally, the existing techniques utilize Massachusetts Institute of Technology-Beth Israel Hospital arrhythmia database to evaluate the classification performance. The classification performance of automated techniques also depends on ECG data used for training and testing of the classifier. It is expected that the performance should be evaluated using a variety of ECG signals including the cases of inter-patient and intra-patient paradigm. The existing techniques also require to deal with the class-imbalance problem. In addition to this, a specific partition-ratio between training and testing datasets should be maintained for fair comparison of performance of different techniques.
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Affiliation(s)
- Chandan Kumar Jha
- Department of Electronics & Communication Engineering, Indian Institute of Information Technology Bhagalpur, India
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Moreno-Sánchez PA, García-Isla G, Corino VDA, Vehkaoja A, Brukamp K, van Gils M, Mainardi L. ECG-based data-driven solutions for diagnosis and prognosis of cardiovascular diseases: A systematic review. Comput Biol Med 2024; 172:108235. [PMID: 38460311 DOI: 10.1016/j.compbiomed.2024.108235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 02/07/2024] [Accepted: 02/25/2024] [Indexed: 03/11/2024]
Abstract
Cardiovascular diseases (CVD) are a leading cause of death globally, and result in significant morbidity and reduced quality of life. The electrocardiogram (ECG) plays a crucial role in CVD diagnosis, prognosis, and prevention; however, different challenges still remain, such as an increasing unmet demand for skilled cardiologists capable of accurately interpreting ECG. This leads to higher workload and potential diagnostic inaccuracies. Data-driven approaches, such as machine learning (ML) and deep learning (DL) have emerged to improve existing computer-assisted solutions and enhance physicians' ECG interpretation of the complex mechanisms underlying CVD. However, many ML and DL models used to detect ECG-based CVD suffer from a lack of explainability, bias, as well as ethical, legal, and societal implications (ELSI). Despite the critical importance of these Trustworthy Artificial Intelligence (AI) aspects, there is a lack of comprehensive literature reviews that examine the current trends in ECG-based solutions for CVD diagnosis or prognosis that use ML and DL models and address the Trustworthy AI requirements. This review aims to bridge this knowledge gap by providing a systematic review to undertake a holistic analysis across multiple dimensions of these data-driven models such as type of CVD addressed, dataset characteristics, data input modalities, ML and DL algorithms (with a focus on DL), and aspects of Trustworthy AI like explainability, bias and ethical considerations. Additionally, within the analyzed dimensions, various challenges are identified. To these, we provide concrete recommendations, equipping other researchers with valuable insights to understand the current state of the field comprehensively.
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Affiliation(s)
| | - Guadalupe García-Isla
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Italy
| | - Valentina D A Corino
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Italy
| | - Antti Vehkaoja
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - Mark van Gils
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Luca Mainardi
- Department of Electronics Information and Bioengineering, Politecnico di Milano, Italy
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Safdar MF, Nowak RM, Pałka P. Pre-Processing techniques and artificial intelligence algorithms for electrocardiogram (ECG) signals analysis: A comprehensive review. Comput Biol Med 2024; 170:107908. [PMID: 38217973 DOI: 10.1016/j.compbiomed.2023.107908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 01/15/2024]
Abstract
Electrocardiogram (ECG) are the physiological signals and a standard test to measure the heart's electrical activity that depicts the movement of cardiac muscles. A review study has been conducted on ECG signals analysis with the help of artificial intelligence (AI) methods over the last ten years i.e., 2012-22. Primarily, the method of ECG analysis by software systems was divided into classical signal processing (e.g. spectrograms or filters), machine learning (ML) and deep learning (DL), including recursive models, transformers and hybrid. Secondly, the data sources and benchmark datasets were depicted. Authors grouped resources by ECG acquisition methods into hospital-based portable machines and wearable devices. Authors also included new trends like advanced pre-processing, data augmentation, simulations and agent-based modeling. The study found improvement in ECG examination perfection made each year through ML, DL, hybrid models, and transformers. Convolutional neural networks and hybrid models were more targeted and proved efficient. The transformer model extended the accuracy from 90% to 98%. The Physio-Net library helps acquire ECG signals, including the popular benchmark databases such as MIT-BIH, PTB, and challenging datasets. Similarly, wearable devices have been established as a appropriate option for monitoring patient health without the time and place limitations and are also helpful for AI model calibration with so far accuracy of 82%-83% on Samsung smartwatch. In the pre-processing signals, spectrogram generation through Fourier and wavelet transformations are erected leading approaches promoting on average accuracy of 90%-95%. Likewise, data enhancement using geometrical techniques is well-considered; however, extraction and concatenation-based methods need attention. As the what-if analysis in healthcare or cardiac issues can be performed using a complex simulation, the study reviews agent-based modeling and simulation approaches for cardiovascular risk event assessment.
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Affiliation(s)
- Muhammad Farhan Safdar
- Institute of Computer Science, Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-665 Warsaw, Poland.
| | - Robert Marek Nowak
- Institute of Computer Science, Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-665 Warsaw, Poland
| | - Piotr Pałka
- Institute of Control and Computation Engineering, Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-665 Warsaw, Poland
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Chopannejad S, Roshanpoor A, Sadoughi F. Attention-assisted hybrid CNN-BILSTM-BiGRU model with SMOTE-Tomek method to detect cardiac arrhythmia based on 12 -lead electrocardiogram signals. Digit Health 2024; 10:20552076241234624. [PMID: 38449680 PMCID: PMC10916475 DOI: 10.1177/20552076241234624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/26/2024] [Indexed: 03/08/2024] Open
Abstract
Objectives Cardiac arrhythmia is one of the most severe cardiovascular diseases that can be fatal. Therefore, its early detection is critical. However, detecting types of arrhythmia by physicians based on visual identification is time-consuming and subjective. Deep learning can develop effective approaches to classify arrhythmias accurately and quickly. This study proposed a deep learning approach developed based on a Chapman-Shaoxing electrocardiogram (ECG) dataset signal to detect seven types of arrhythmias. Method Our DNN model is a hybrid CNN-BILSTM-BiGRU algorithm assisted by a multi-head self-attention mechanism regarding the challenging problem of classifying various arrhythmias of ECG signals. Additionally, the synthetic minority oversampling technique (SMOTE)-Tomek technique was utilized to address the data imbalance problem to detect and classify cardiac arrhythmias. Result The proposed model, trained with a single lead, was tested using a dataset containing 10,466 participants. The performance of the algorithm was evaluated using a random split validation approach. The proposed algorithm achieved an accuracy of 98.57% by lead II and 98.34% by lead aVF for the classification of arrhythmias. Conclusion We conducted an analysis of single-lead ECG signals to evaluate the effectiveness of our proposed hybrid model in diagnosing and classifying different types of arrhythmias. We trained separate classification models using each individual signal lead. Additionally, we implemented the SMOTE-Tomek technique along with cross-entropy loss as a cost function to address the class imbalance problem. Furthermore, we utilized a multi-headed self-attention mechanism to adjust the network structure and classify the seven arrhythmia classes. Our model achieved high accuracy and demonstrated good generalization ability in detecting ECG arrhythmias. However, further testing of the model with diverse datasets is crucial to validate its performance.
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Affiliation(s)
- Sara Chopannejad
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Roshanpoor
- Department of Computer, Yadegar-e-Imam Khomeini (RAH), Janat-abad Branch, Islamic Azad University, Tehran, Iran
| | - Farahnaz Sadoughi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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