Artificial intelligence-enhanced ECGs may speed heart failure diagnosis and treatment

August 04, 2020

DALLAS, August 4, 2020 -- When people seek emergency care for shortness of breath, a routine electrocardiogram (ECG or EKG) enhanced by artificial intelligence (AI) is better than standard blood tests at determining if the cause is heart failure, according to new research published today in Circulation: Arrhythmia and Electrophysiology, an American Heart Association journal.

"Determining why someone has shortness of breath is challenging for emergency department physicians, and this AI-enabled ECG provides a rapid and effective method to screen these patients for left ventricular systolic dysfunction," said Demilade Adedinsewo, M.D., M.P.H., lead author of the study and chief fellow in the division of cardiovascular medicine at Mayo Clinic in Jacksonville, Florida.

The left ventricle supplies most of the heart's pumping power, so it is larger than the other chambers and essential for normal function. In left ventricular systolic dysfunction (LVSD), the left ventricle is weakened and must work harder to maintain adequate blood flow to the body.

In a typical year, about 1.2 million people go to emergency departments because they are short of breath. This year, the numbers are far higher because difficulty breathing is one of the hallmark symptoms of a COVID-19 infection. When heart problems are suspected, patients in the emergency department usually have an ECG performed - a quick, 10-second recording of the heart's electrical activity.

"An abnormal ECG raises concern about underlying cardiac abnormalities but are not specific for heart failure," Adedinsewo said.

Emergency department physicians also rely on blood levels of natriuretic peptides. These biomarkers are elevated in the blood when heart failure is present. However, these biomarker levels are also affected by obesity, age, kidney disease, severe infection, high blood pressure in the vessels that bring blood to the lungs (pulmonary hypertension), abnormal heart rhythms and a specific heart failure medication.

To create the AI-enhanced ECG, Mayo Clinic researchers used data on thousands of patients to train computers to distinguish between the ECG patterns of people ultimately diagnosed with LVSD and those without LVSD. In about 10 seconds, standard ECG recordings can be analyzed with the resulting AI software application to identify likely LVSD.

In this study, researchers tested the accuracy of the AI-enhanced ECG to identify LVSD in emergency room patients with shortness of breath compared to the results of biomarker blood tests. They applied the AI-enhancement to the ECGs of 1,606 patients (average age 68, 47% female, 91% white) who had received an ECG and blood testing in the emergency department, later followed by definitive testing using an echocardiogram.

Researchers found:AI-enhanced ECGs are not widely available. In May, the Food and Drug Administration granted emergency use authorization of the AI-enhanced ECG algorithm to screen for LVSD in people with confirmed or suspected COVID-19 disease.

The current study is limited by being a retrospective analysis of previous emergency department visits.
-end-
Co-authors are Rickey E. Carter, Ph.D.; Zachi Attia, M.Sc.; Patrick Johnson, B.S.; Anthony H. Kashou, M.D.; Jennifer L. Dugan, M.D.; Michael Albus, M.D.; Johnathan M. Sheele, M.D., M.P.H.; M. Fernanda Bellolio, M.D., M.S.; Paul Friedman, M.D.; Francisco Lopez-Jimenez, M.D., M.Sc.; and Peter Noseworthy, M.D. Author disclosures are in the manuscript.

Additional Resources:

Available multimedia is on right column of release link - https://newsroom.heart.org/news/artificial-intelligence-enhanced-ecgs-may-speed-heart-failure-diagnosis-and-treatment?preview=68a685ddc0f770a730ca680f6e7ff5db

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.