Prediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation
Abstract Risk factors for pacemaker-induced cardiomyopathy (PICM) have been previously reported, including a high burden of right ventricular pacing, lower left ventricular ejection fraction, a wide QRS duration, and left bundle branch block before pacemaker implantation (PMI). However, predicting t...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2024-03-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-57418-y |
| _version_ | 1797247293656662016 |
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| author | Mitsunori Oida Takuya Mizutani Eriko Hasumi Katsuhito Fujiu Kosaku Goto Kunihiro Kani Tsukasa Oshima Takumi J. Matsubara Yu Shimizu Gaku Oguri Toshiya Kojima Issei Komuro |
| author_facet | Mitsunori Oida Takuya Mizutani Eriko Hasumi Katsuhito Fujiu Kosaku Goto Kunihiro Kani Tsukasa Oshima Takumi J. Matsubara Yu Shimizu Gaku Oguri Toshiya Kojima Issei Komuro |
| author_sort | Mitsunori Oida |
| collection | DOAJ |
| description | Abstract Risk factors for pacemaker-induced cardiomyopathy (PICM) have been previously reported, including a high burden of right ventricular pacing, lower left ventricular ejection fraction, a wide QRS duration, and left bundle branch block before pacemaker implantation (PMI). However, predicting the development of PICM remains challenging. This study aimed to use a convolutional neural network (CNN) model, based on clinical findings before PMI, to predict the development of PICM. Out of a total of 561 patients with dual-chamber PMI, 165 (mean age 71.6 years, 89 men [53.9%]) who underwent echocardiography both before and after dual-chamber PMI were enrolled. During a mean follow-up period of 1.7 years, 47 patients developed PICM. A CNN algorithm for prediction of the development of PICM was constructed based on a dataset prior to PMI that included 31 variables such as age, sex, body mass index, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, severity of mitral regurgitation, severity of tricuspid regurgitation, ischemic heart disease, diabetes mellitus, hypertension, heart failure, New York Heart Association class, atrial fibrillation, the etiology of bradycardia (sick sinus syndrome or atrioventricular block) , right ventricular (RV) lead tip position (apex, septum, left bundle, His bundle, RV outflow tract), left bundle branch block, QRS duration, white blood cell count, haemoglobin, platelet count, serum total protein, albumin, aspartate transaminase, alanine transaminase, estimated glomerular filtration rate, sodium, potassium, C-reactive protein, and brain natriuretic peptide. The accuracy, sensitivity, specificity, and area under the curve of the CNN model were 75.8%, 55.6%, 83.3% and 0.78 respectively. The CNN model could accurately predict the development of PICM using clinical findings before PMI. This model could be useful for screening patients at risk of developing PICM, ensuring timely upgrades to physiological pacing to avoid missing the optimal intervention window. |
| first_indexed | 2024-04-24T19:56:24Z |
| format | Article |
| id | doaj.art-cd3e4f7c6bf64c7695a1e8b49bbff37c |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-24T19:56:24Z |
| publishDate | 2024-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-cd3e4f7c6bf64c7695a1e8b49bbff37c2024-03-24T12:19:48ZengNature PortfolioScientific Reports2045-23222024-03-011411810.1038/s41598-024-57418-yPrediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantationMitsunori Oida0Takuya Mizutani1Eriko Hasumi2Katsuhito Fujiu3Kosaku Goto4Kunihiro Kani5Tsukasa Oshima6Takumi J. Matsubara7Yu Shimizu8Gaku Oguri9Toshiya Kojima10Issei Komuro11Department of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Radiology, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoDepartment of Cardiovascular Medicine, Graduate School of Medicine, The University of TokyoAbstract Risk factors for pacemaker-induced cardiomyopathy (PICM) have been previously reported, including a high burden of right ventricular pacing, lower left ventricular ejection fraction, a wide QRS duration, and left bundle branch block before pacemaker implantation (PMI). However, predicting the development of PICM remains challenging. This study aimed to use a convolutional neural network (CNN) model, based on clinical findings before PMI, to predict the development of PICM. Out of a total of 561 patients with dual-chamber PMI, 165 (mean age 71.6 years, 89 men [53.9%]) who underwent echocardiography both before and after dual-chamber PMI were enrolled. During a mean follow-up period of 1.7 years, 47 patients developed PICM. A CNN algorithm for prediction of the development of PICM was constructed based on a dataset prior to PMI that included 31 variables such as age, sex, body mass index, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left atrial diameter, severity of mitral regurgitation, severity of tricuspid regurgitation, ischemic heart disease, diabetes mellitus, hypertension, heart failure, New York Heart Association class, atrial fibrillation, the etiology of bradycardia (sick sinus syndrome or atrioventricular block) , right ventricular (RV) lead tip position (apex, septum, left bundle, His bundle, RV outflow tract), left bundle branch block, QRS duration, white blood cell count, haemoglobin, platelet count, serum total protein, albumin, aspartate transaminase, alanine transaminase, estimated glomerular filtration rate, sodium, potassium, C-reactive protein, and brain natriuretic peptide. The accuracy, sensitivity, specificity, and area under the curve of the CNN model were 75.8%, 55.6%, 83.3% and 0.78 respectively. The CNN model could accurately predict the development of PICM using clinical findings before PMI. This model could be useful for screening patients at risk of developing PICM, ensuring timely upgrades to physiological pacing to avoid missing the optimal intervention window.https://doi.org/10.1038/s41598-024-57418-y |
| spellingShingle | Mitsunori Oida Takuya Mizutani Eriko Hasumi Katsuhito Fujiu Kosaku Goto Kunihiro Kani Tsukasa Oshima Takumi J. Matsubara Yu Shimizu Gaku Oguri Toshiya Kojima Issei Komuro Prediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation Scientific Reports |
| title | Prediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation |
| title_full | Prediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation |
| title_fullStr | Prediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation |
| title_full_unstemmed | Prediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation |
| title_short | Prediction of pacemaker-induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation |
| title_sort | prediction of pacemaker induced cardiomyopathy using a convolutional neural network based on clinical findings prior to pacemaker implantation |
| url | https://doi.org/10.1038/s41598-024-57418-y |
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