用仿真数据训练神经网络,从动脉波形预测心脏关键指标。
Leveraging Cardiovascular Simulations for In-Vivo Prediction of Cardiac Biomarkers
- 基于仿真数据训练神经后验估计器,解决生理参数反推难题。
- 可精准预测心率、心输出量等4个临床重要生物标志物。
- 适合临床监测中需要高可信度预测的场景。
全身血流动力学模拟器已成为研究心血管系统的重要工具,但将观测数据(如特定位置的动脉压力波形)反推为合理生理参数的逆问题仍具挑战。我们借助基于仿真的推理最新进展,将该问题建模为统计推断,利用公开发布的大型心脏仿真数据集训练了压缩神经后验估计器,并引入随机项以更好匹配真实测量。该框架可融合在体数据进一步提升对真实数据的预测能力。仿真结果表明,该方法能精细量化单次测量的不确定性,可靠预测四个临床关注的生物标志物——心率、心输出量、外周血管阻力和左心室射血时间,仅需动脉压力波形与光电容积脉搏波图。此外,在VitalDB数据集上验证了其在体预测能力,准确捕捉心输出量与血管阻力的时间变化趋势。模型预测误差随预测不确定性单调上升,支持自动剔除不可靠测量。
原文摘要 · Abstract (English)
Whole-body hemodynamics simulators, which model blood flow and pressure waveforms as functions of physiological parameters, are now essential tools for studying cardiovascular systems. However, solving the corresponding inverse problem of mapping observations (e.g., arterial pressure waveforms at specific locations in the arterial network) back to plausible physiological parameters remains challenging. Leveraging recent advances in simulation-based inference, we cast this problem as statistical inference by training an amortized neural posterior estimator on a newly built large dataset of cardiac simulations that we publicly release. To better align simulated data with real-world measurements, we incorporate stochastic elements modeling exogenous effects. The proposed framework can further integrate in-vivo data sources to refine its predictive capabilities on real-world data. In silico, we demonstrate that the proposed framework enables finely quantifying uncertainty associated with individual measurements, allowing trustworthy prediction of four biomarkers of clinical interest--namely Heart Rate, Cardiac Output, Systemic Vascular Resistance, and Left Ventricular Ejection Time--from arterial pressure waveforms and photoplethysmograms. Furthermore, we validate the framework in vivo, where our method accurately captures temporal trends in CO and SVR monitoring on the VitalDB dataset. Finally, the predictive error made by the model monotonically increases with the predicted uncertainty, thereby directly supporting the automatic rejection of unusable measurements.
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