用AI分析超声心动图,自动评估心脏疾病风险。
Acoustic Index: A Novel AI-Driven Parameter for Cardiac Disease Risk Stratification Using Echocardiography
- 融合动态分解与神经网络,从超声视频中提取心肌运动模式。
- 在736人队列中,判别准确率AUC达0.89,敏感性特异性均超0.8。
- 结果可解释、不依赖设备,适合早期筛查和长期追踪。
传统超声参数如射血分数(EF)和全球纵向应变(GLS)在心脏功能早期异常检测中存在局限:EF常保持正常而实际已有病变,且GLS受负荷状态和厂商差异影响。亟需可复现、可解释、操作者无关的参数以捕捉细微且全局的心脏功能变化。本文提出声学指数(Acoustic Index),一种基于AI的新型超声心动图参数,通过标准超声视图量化心脏功能障碍。该模型结合基于Koopman算子理论的扩展动态模式分解(EDMD)与融合临床数据的混合神经网络,从心动图序列中提取时空动态特征,利用注意力机制加权并经流形学习融合,输出0(低风险)到1(高风险)的连续评分。在包含多种心脏病理及正常对照的736例前瞻性队列中,该指数在独立测试集上达到0.89的曲线下面积(AUC)。五折交叉验证显示,模型鲁棒性强,独立数据下敏感性和特异性均超过0.8。阈值分析表明,在临界点附近敏感性与特异性保持稳定平衡。声学指数是一种物理引导、可解释的AI生物标志物,具有作为可扩展、厂商无关工具用于早期检测、分诊与长期监测的潜力。未来工作包括外部验证、纵向研究及适配特定疾病分类器。
原文摘要 · Abstract (English)
Traditional echocardiographic parameters such as ejection fraction (EF) and global longitudinal strain (GLS) have limitations in the early detection of cardiac dysfunction. EF often remains normal despite underlying pathology, and GLS is influenced by load conditions and vendor variability. There is a growing need for reproducible, interpretable, and operator-independent parameters that capture subtle and global cardiac functional alterations. We introduce the Acoustic Index, a novel AI-derived echocardiographic parameter designed to quantify cardiac dysfunction from standard ultrasound views. The model combines Extended Dynamic Mode Decomposition (EDMD) based on Koopman operator theory with a hybrid neural network that incorporates clinical metadata. Spatiotemporal dynamics are extracted from echocardiographic sequences to identify coherent motion patterns. These are weighted via attention mechanisms and fused with clinical data using manifold learning, resulting in a continuous score from 0 (low risk) to 1 (high risk). In a prospective cohort of 736 patients, encompassing various cardiac pathologies and normal controls, the Acoustic Index achieved an area under the curve (AUC) of 0.89 in an independent test set. Cross-validation across five folds confirmed the robustness of the model, showing that both sensitivity and specificity exceeded 0.8 when evaluated on independent data. Threshold-based analysis demonstrated stable trade-offs between sensitivity and specificity, with optimal discrimination near this threshold. The Acoustic Index represents a physics-informed, interpretable AI biomarker for cardiac function. It shows promise as a scalable, vendor-independent tool for early detection, triage, and longitudinal monitoring. Future directions include external validation, longitudinal studies, and adaptation to disease-specific classifiers.
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