用肺功能数据和年龄等信息,提前预测右心衰竭风险。
Artificial Intelligence-Enabled Spirometry for Early Detection of Right Heart Failure
- 通过自监督学习从肺功能曲线中提取特征,再融合人口信息
- 在2.6万人数据上达到0.75的预测准确率,高危人群超0.84
- 适合慢性肾病、心脏瓣膜病等高风险人群早期筛查
右心衰竭(RHF)是右心室结构或功能异常导致的疾病,与高发病率和死亡率相关。肺部疾病常增加右心室负荷,进而引发RHF。因此,从有基础肺病的人群中筛查出已发展为肺心病并可能进展为RHF的患者至关重要。本文提出一种自监督表示学习方法,利用肺功能检测(spirogram)时间序列数据,实现对肺心病患者早期RHF的识别。该模型分为两个阶段:第一阶段采用变分自编码器(VAE-encoder)在数据增强的无标签数据上训练,学习肺功能曲线的鲁棒低维表示;第二阶段将该表示与人口学信息融合,输入CatBoost分类器进行下游RHF预测任务。在英国生物样本库中筛选出的26,617名个体数据上,模型在检测RHF时获得0.7501的AUROC,显示出较强的群体区分能力。进一步在高风险临床子人群中评估,对74名慢性肾病(CKD)患者测试集达0.8194,对64名瓣膜性心脏病(VHD)患者达0.8413。结果表明该模型在高风险人群中具有显著预测潜力。本研究展示了结合肺功能时间序列与人口学数据的自监督学习方法,在临床实践中早期检测RHF方面的前景。
原文摘要 · Abstract (English)
Right heart failure (RHF) is a disease characterized by abnormalities in the structure or function of the right ventricle (RV), which is associated with high morbidity and mortality. Lung disease often causes increased right ventricular load, leading to RHF. Therefore, it is very important to screen out patients with cor pulmonale who develop RHF from people with underlying lung diseases. In this work, we propose a self-supervised representation learning method to early detecting RHF from patients with cor pulmonale, which uses spirogram time series to predict patients with RHF at an early stage. The proposed model is divided into two stages. The first stage is the self-supervised representation learning-based spirogram embedding (SLSE) network training process, where the encoder of the Variational autoencoder (VAE-encoder) learns a robust low-dimensional representation of the spirogram time series from the data-augmented unlabeled data. Second, this low-dimensional representation is fused with demographic information and fed into a CatBoost classifier for the downstream RHF prediction task. Trained and tested on a carefully selected subset of 26,617 individuals from the UK Biobank, our model achieved an AUROC of 0.7501 in detecting RHF, demonstrating strong population-level distinction ability. We further evaluated the model on high-risk clinical subgroups, achieving AUROC values of 0.8194 on a test set of 74 patients with chronic kidney disease (CKD) and 0.8413 on a set of 64 patients with valvular heart disease (VHD). These results highlight the model's potential utility in predicting RHF among clinically elevated-risk populations. In conclusion, this study presents a self-supervised representation learning approach combining spirogram time series and demographic data, demonstrating promising potential for early RHF detection in clinical practice.
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