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Estimation of Segmental Longitudinal Strain in Transesophageal Echocardiography by Deep Learning

Taskén, Anders Austlid, Judge, Thierry, Berg, Erik Andreas Rye, Yu, Jinyang, Grenne, Bjørnar, Lindseth, Frank, Aakhus, Svend, Jodoin, Pierre-Marc, Duchateau, Nicolas, Bernard, Olivier, Kiss, Gabriel

arXiv.org Artificial Intelligence

Segmental longitudinal strain (SLS) of the left ventricle (LV) is an important prognostic indicator for evaluating regional LV dysfunction, in particular for diagnosing and managing myocardial ischemia. Current techniques for strain estimation require significant manual intervention and expertise, limiting their efficiency and making them too resource-intensive for monitoring purposes. This study introduces the first automated pipeline, autoStrain, for SLS estimation in transesophageal echocardiography (TEE) using deep learning (DL) methods for motion estimation. We present a comparative analysis of two DL approaches: TeeFlow, based on the RAFT optical flow model for dense frame-to-frame predictions, and TeeTracker, based on the CoTracker point trajectory model for sparse long-sequence predictions. As ground truth motion data from real echocardiographic sequences are hardly accessible, we took advantage of a unique simulation pipeline (SIMUS) to generate a highly realistic synthetic TEE (synTEE) dataset of 80 patients with ground truth myocardial motion to train and evaluate both models. Our evaluation shows that TeeTracker outperforms TeeFlow in accuracy, achieving a mean distance error in motion estimation of 0.65 mm on a synTEE test dataset. Clinical validation on 16 patients further demonstrated that SLS estimation with our autoStrain pipeline aligned with clinical references, achieving a mean difference (95\% limits of agreement) of 1.09% (-8.90% to 11.09%). Incorporation of simulated ischemia in the synTEE data improved the accuracy of the models in quantifying abnormal deformation. Our findings indicate that integrating AI-driven motion estimation with TEE can significantly enhance the precision and efficiency of cardiac function assessment in clinical settings.




TREAT-Net: Tabular-Referenced Echocardiography Analysis for Acute Coronary Syndrome Treatment Prediction

Kim, Diane, To, Minh Nguyen Nhat, Abdalla, Sherif, Tsang, Teresa S. M., Abolmaesumi, Purang, Luong, and Christina

arXiv.org Artificial Intelligence

Coronary angiography remains the gold standard for diagnosing Acute Coronary Syndrome (ACS). However, its resource-intensive and invasive nature can expose patients to procedural risks and diagnostic delays, leading to postponed treatment initiation. In this work, we introduce TREAT-Net, a multimodal deep learning framework for ACS treatment prediction that leverages non-invasive modalities, including echocardiography videos and structured clinical records. TREAT-Net integrates tabular-guided cross-attention to enhance video interpretation, along with a late fusion mechanism to align predictions across modalities. Trained on a dataset of over 9,000 ACS cases, the model outperforms unimodal and non-fused baselines, achieving a balanced accuracy of 67.6% and an AUROC of 71.1%. Cross-modality agreement analysis demonstrates 88.6% accuracy for intervention prediction.


Application of Contrastive Learning on ECG Data: Evaluating Performance in Japanese and Classification with Around 100 Labels

Takahashi, Junichiro, Guan, JingChuan, Sato, Masataka, Baba, Kaito, Haruguchi, Kazuto, Nagashima, Daichi, Kodera, Satoshi, Takeda, Norihiko

arXiv.org Artificial Intelligence

The electrocardiogram (ECG) is a fundamental tool in cardiovascular diagnostics due to its powerful and non-invasive nature. One of the most critical usages is to determine whether more detailed examinations are necessary, with users ranging across various levels of expertise. Given this diversity in expertise, it is essential to assist users to avoid critical errors. Recent studies in machine learning have addressed this challenge by extracting valuable information from ECG data. Utilizing language models, these studies have implemented multimodal models aimed at classifying ECGs according to labeled terms. However, the number of classes was reduced, and it remains uncertain whether the technique is effective for languages other than English. To move towards practical application, we utilized ECG data from regular patients visiting hospitals in Japan, maintaining a large number of Japanese labels obtained from actual ECG readings. Using a contrastive learning framework, we found that even with 98 labels for classification, our Japanese-based language model achieves accuracy comparable to previous research. This study extends the applicability of multimodal machine learning frameworks to broader clinical studies and non-English languages.


Comprehensive Benchmarking of Machine Learning Methods for Risk Prediction Modelling from Large-Scale Survival Data: A UK Biobank Study

Oexner, Rafael R., Schmitt, Robin, Ahn, Hyunchan, Shah, Ravi A., Zoccarato, Anna, Theofilatos, Konstantinos, Shah, Ajay M.

arXiv.org Artificial Intelligence

Predictive modelling is vital to guide preventive efforts. Whilst large-scale prospective cohort studies and a diverse toolkit of available machine learning (ML) algorithms have facilitated such survival task efforts, choosing the best-performing algorithm remains challenging. Benchmarking studies to date focus on relatively small-scale datasets and it is unclear how well such findings translate to large datasets that combine omics and clinical features. We sought to benchmark eight distinct survival task implementations, ranging from linear to deep learning (DL) models, within the large-scale prospective cohort study UK Biobank (UKB). We compared discrimination and computational requirements across heterogenous predictor matrices and endpoints. Finally, we assessed how well different architectures scale with sample sizes ranging from n = 5,000 to n = 250,000 individuals. Our results show that discriminative performance across a multitude of metrices is dependent on endpoint frequency and predictor matrix properties, with very robust performance of (penalised) COX Proportional Hazards (COX-PH) models. Of note, there are certain scenarios which favour more complex frameworks, specifically if working with larger numbers of observations and relatively simple predictor matrices. The observed computational requirements were vastly different, and we provide solutions in cases where current implementations were impracticable. In conclusion, this work delineates how optimal model choice is dependent on a variety of factors, including sample size, endpoint frequency and predictor matrix properties, thus constituting an informative resource for researchers working on similar datasets. Furthermore, we showcase how linear models still display a highly effective and scalable platform to perform risk modelling at scale and suggest that those are reported alongside non-linear ML models.


GEM: Empowering MLLM for Grounded ECG Understanding with Time Series and Images

Lan, Xiang, Wu, Feng, He, Kai, Zhao, Qinghao, Hong, Shenda, Feng, Mengling

arXiv.org Artificial Intelligence

While recent multimodal large language models (MLLMs) have advanced automated ECG interpretation, they still face two key limitations: (1) insufficient multimodal synergy between time series signals and visual ECG representations, and (2) limited explainability in linking diagnoses to granular waveform evidence. We introduce GEM, the first MLLM unifying ECG time series, 12-lead ECG images and text for grounded and clinician-aligned ECG interpretation. GEM enables feature-grounded analysis, evidence-driven reasoning, and a clinician-like diagnostic process through three core innovations: a dual-encoder framework extracting complementary time series and image features, cross-modal alignment for effective multimodal understanding, and knowledge-guided instruction generation for generating high-granularity grounding data (ECG-Grounding) linking diagnoses to measurable parameters ($e.g.$, QRS/PR Intervals). Additionally, we propose the Grounded ECG Understanding task, a clinically motivated benchmark designed to comprehensively assess the MLLM's capability in grounded ECG understanding. Experimental results on both existing and our proposed benchmarks show GEM significantly improves predictive performance (CSN $7.4\% \uparrow$), explainability ($22.7\% \uparrow$), and grounding ($24.8\% \uparrow$), making it more suitable for real-world clinical applications. GitHub repository: https://github.com/lanxiang1017/GEM.git


Advancements in Myocardial Infarction Detection and Classification Using Wearable Devices: A Comprehensive Review

S, Abhijith, Rajesh, Arjun, Manoj, Mansi, Kollannur, Sandra Davis, R, Sujitta V, Panachakel, Jerrin Thomas

arXiv.org Artificial Intelligence

The following sections will delve deep into the comparisons Myocardial infarction (MI), also known as a heart attack, is between various MI classification methods put forward by caused by reduced blood flow to the heart chambers. MI can researchers over the years, which will facilitate a clear understanding be silent and undetected, or it can have serious effects and lead on the same.The paper explores various methodologies to death. Most myocardial infarctions are caused by coronary including machine learning,deep learning, VLSI, and IoTbased artery disease. When a coronary artery blockage occurs, there methods contributing to efficient and accurate detection is a lack of oxygen within the heart muscle. Prolonged lack and classification of Myocardial infarction that can be implemented of oxygen supply to the heart can lead to death and necrosis in wearables for a timely analysis.By synthesizing of myocardial cells. Patients experience chest discomfort or findings from relevant studies, the review highlights strengths, tightness that can spread to the neck, jaw, shoulders, or arms.