论文的摘要
Left ventricular hypertrophy (LVH) indicates subclinical organ damage, associating with the incidence of cardiovascular diseases. From the medical perspective, electrocardiogram (ECG) is a low-cost, non-invasive, and easily reproducible tool that is often used as a preliminary diagnosis for the detection of heart disease. Nowadays, there are many criteria for assessing LVH by ECG. These criteria usually include that voltage combination of RS peaks in multi-lead ECG must be greater than one or more thresholds for diagnosis. We developed a system for detecting LVH using ECG signals by two steps: firstly, the R-peak and S-valley amplitudes of the 12-lead ECG were extracted to automatically obtain a total of 24 features and ECG beats of each case (LVH or non-LVH) were segmented; secondly, a back propagation neural network (BPN) was trained using a dataset with these features. Echocardiography (ECHO) was used as the gold standard for diagnosing LVH. The number of LVH cases (of a Taiwanese population) identified was 173. As each ECG sequence generally included 8 to 13 cycles (heartbeats) due to differences in heart rate, etc., we identified 1466 ECG cycles of LVH patients after beat segmentation. Results showed that our BPN model for detecting LVH reached the testing accuracy, precision, sensitivity, and specificity of 0.961, 0.958, 0.966 and 0.956, respectively. Detection performances of our BPN model, on the whole, outperform 7 methods using ECG criteria and many ECG-based artificial intelligence (AI) models reported previously for detecting LVH.
阅读笔记
本文介绍了一种使用心电图信号检测左心室肥厚的新系统。左心室肥厚是一种亚临床器官损伤，与心血管疾病的发生率有关。从医学角度来看，心电图是一种低成本、非侵入性和易于重复的工具，常用于检测心脏疾病的初步诊断。现在，有许多评估LVH的标准，其中包括多导联ECG中RS峰值电压组合必须大于一个或多个诊断阈值。
该系统通过两个步骤来检测LVH：首先提取12导联ECG的R峰和S谷振幅以自动获取24个特征，并分割每个案例（LVH或非LVH）的ECG节拍；其次，使用这些特征对一个数据集进行反向传播神经网络（BPN）进行训练。超声心动图（ECHO）被用作诊断LVH的金标准。在台湾人群中确定了173例LVH病例。
该系统为LVH检测提供了一种新方法，并且具有潜在的临床应用前景。
本文作者介绍了该文章所采用的开放获取许可证和版权信息。该文章采用的是Creative Commons Attribution 4.0 International License，这意味着任何人都可以自由地共享、复制、分发和传播文章，前提是必须给出适当的署名，并且不得修改原始作品。
此外，本文还介绍了该系统的优点和局限性。优点包括：使用ECG进行LVH检测具有低成本、非侵入性和易于重复等优点；该系统具有高准确性和良好的鲁棒性，可以在不同人群中使用。局限性包括：该系统需要大量的数据进行训练，因此可能存在过拟合的风险；该系统只能检测LVH，不能检测其他心脏疾病。
总之，本文介绍了一种新的LVH检测方法，并且该方法具有潜在的临床应用前景。这项研究为心脏疾病的早期诊断提供了一种低成本、非侵入性和易于重复的工具，可以帮助医生更早地发现患者的心脏问题，并采取相应措施进行治疗。
参考文献
Liu, CW., Wu, FH., Hu, YL. et al. Left ventricular hypertrophy detection using electrocardiographic signal. Sci Rep 13, 2556 (2023). https://doi.org/10.1038/s41598-023-28325-5
