Coronary artery disease (CAD) remains a major global health burden. Accurate identification of the culprit vessel and assessment of stenosis severity are essential for guiding individualized therapy. Although coronary CT angiography (CCTA) is the first-line non-invasive modality for CAD diagnosis, its dependence on high-end equipment, radiation exposure, and strict patient cooperation limits large-scale use. With advances in artificial intelligence (AI) and the widespread availability of electrocardiography (ECG), AI-ECG offers a promising alternative for CAD screening. In this study, we developed an interpretable AI-ECG model to predict severe or complete stenosis of the four major coronary arteries on CCTA. On the internal validation set, the model's AUCs for the right coronary artery (RCA), left main coronary artery (LM), left anterior descending artery (LAD), and left circumflex artery (LCX) were 0.794, 0.818, 0.744, and 0.755, respectively; on the external validation set, the AUCs reached 0.749, 0.971, 0.667, and 0.727, respectively. Performance remained stable in a clinically normal-ECG subset, indicating robustness beyond overt ECG abnormalities. Subgroup analyses across demographic and acquisition-time strata further confirmed model stability. Risk stratification based on vessel-specific incidence thresholds showed consistent separation on calibration and cumulative event curves. Interpretability analyses revealed distinct waveform differences between high- and low-risk groups, highlighting key electrophysiological regions contributing to model decisions and offering new insights into the ECG correlates of coronary stenosis.

Coronary artery calcium (CAC) scoring plays a crucial role in the early detection and risk stratification of coronary artery disease (CAD). In this study, we focus on non-contrast coronary computed tomography angiography (CCTA) scans, which are commonly used for early calcification detection in clinical settings. To address the challenge of limited annotated data, we propose a radiomics-based pipeline that leverages pseudo-labeling to generate training labels, thereby eliminating the need for expert-defined segmentations. Additionally, we explore the use of pretrained foundation models, specifically CT-FM and RadImageNet, to extract image features, which are then used with traditional classifiers. We compare the performance of these deep learning features with that of radiomics features. Evaluation is conducted on a clinical CCTA dataset comprising 182 patients, where individuals are classified into two groups: zero versus non-zero calcium scores. We further investigate the impact of training on non-contrast datasets versus combined contrast and non-contrast datasets, with testing performed only on non-contrast scans. Results show that radiomics-based models significantly outperform CNN-derived embeddings from foundation models (achieving 84% accuracy and p<0.05), despite the unavailability of expert annotations.

Abstract--Cardiovascular disease (CVD) risk stratification remains a major challenge due to its multifactorial nature and limited availability of high-quality labeled datasets. While genomic and electrophysiological data such as SNP variants and ECG phenotypes are increasingly accessible, effectively integrating these modalities in low-label settings is non-trivial. This challenge arises from the scarcity of well-annotated multimodal datasets and the high dimensionality of biological signals, which limit the effectiveness of conventional supervised models. T o address this, we present a few-label multimodal framework that leverages large language models (LLMs) to combine genetic and electro-physiological information for cardiovascular risk stratification. Our approach incorporates a pseudo-label refinement strategy to adaptively distill high-confidence labels from weakly supervised predictions, enabling robust model fine-tuning with only a small set of ground-truth annotations. T o enhance the interpretability, we frame the task as a Chain of Thought (CoT) reasoning problem, prompting the model to produce clinically relevant rationales alongside predictions. Experimental results demonstrate that the integration of multimodal inputs, few-label supervision, and CoT reasoning improves robustness and generalizability across diverse patient profiles. Experimental results using multimodal SNP variants and ECG-derived features demonstrated comparable performance to models trained on the full dataset, underscoring the promise of LLM-based few-label multimodal modeling for advancing personalized cardiovascular care. Cardiovascular disease remains the leading global killer (about 20.5M deaths in 2023), making early risk stratification essential [1]. Early and accurate stratification of at-risk patients is essential for timely interventions and effective disease management.

Reliable risk assessment for carotid atheromatous disease remains a major clinical challenge, as it requires integrating diverse clinical and imaging information in a manner that is transparent and interpretable to clinicians. This study investigates the potential of state-of-the-art and recent large vision-language models (LVLMs) for multimodal carotid plaque assessment by integrating ultrasound imaging (USI) with structured clinical, demographic, laboratory, and protein biomarker data. A framework that simulates realistic diagnostic scenarios through interview-style question sequences is proposed, comparing a range of open-source LVLMs, including both general-purpose and medically tuned models. Zero-shot experiments reveal that even if they are very powerful, not all LVLMs can accurately identify imaging modality and anatomy, while all of them perform poorly in accurate risk classification. To address this limitation, LLaVa-NeXT-Vicuna is adapted to the ultrasound domain using low-rank adaptation (LoRA), resulting in substantial improvements in stroke risk stratification. The integration of multimodal tabular data in the form of text further enhances specificity and balanced accuracy, yielding competitive performance compared to prior convolutional neural network (CNN) baselines trained on the same dataset. Our findings highlight both the promise and limitations of LVLMs in ultrasound-based cardiovascular risk prediction, underscoring the importance of multimodal integration, model calibration, and domain adaptation for clinical translation.

Accurate and interpretable survival analysis remains a core challenge in oncology. With growing multimodal data and the clinical need for transparent models to support validation and trust, this challenge increases in complexity. We propose an interpretable multimodal AI framework to automate survival analysis by integrating clinical variables and computed tomography imaging. Our MultiFIX-based framework uses deep learning to infer survival-relevant features that are further explained: imaging features are interpreted via Grad-CAM, while clinical variables are modeled as symbolic expressions through genetic programming. Risk estimation employs a transparent Cox regression, enabling stratification into groups with distinct survival outcomes. Using the open-source RADCURE dataset for head and neck cancer, MultiFIX achieves a C-index of 0.838 (prediction) and 0.826 (stratification), outperforming the clinical and academic baseline approaches and aligning with known prognostic markers. These results highlight the promise of interpretable multimodal AI for precision oncology with MultiFIX.

Contemporary cardiovascular management involves complex consideration and integration of multimodal cardiac datasets, where each modality provides distinct but complementary physiological characteristics. While the effective integration of multiple modalities could yield a holistic clinical profile that accurately models the true clinical situation with respect to data modalities and their relatives weightings, current methodologies remain limited by: 1) the scarcity of patient- and time-aligned multimodal data; 2) reliance on isolated single-modality or rigid multimodal input combinations; 3) alignment strategies that prioritize cross-modal similarity over complementarity; and 4) a narrow single-task focus. In response to these limitations, a comprehensive multimodal dataset was curated for immediate application, integrating laboratory test results, electrocardiograms, and echocardiograms with clinical outcomes. Subsequently, a unified framework, Textual Guidance Multimodal fusion for Multiple cardiac tasks (TGMM), was proposed. TGMM incorporated three key components: 1) a MedFlexFusion module designed to capture the unique and complementary characteristics of medical modalities and dynamically integrate data from diverse cardiac sources and their combinations; 2) a textual guidance module to derive task-relevant representations tailored to diverse clinical objectives, including heart disease diagnosis, risk stratification and information retrieval; and 3) a response module to produce final decisions for all these tasks. Furthermore, this study systematically explored key features across multiple modalities and elucidated their synergistic contributions in clinical decision-making. Extensive experiments showed that TGMM outperformed state-of-the-art methods across multiple clinical tasks, with additional validation confirming its robustness on another public dataset.

--Cardiovascular disease (CVD) prediction remains a tremendous challenge due to its multifactorial etiology and global burden of morbidity and mortality. Despite the growing availability of genomic and electrophysiological data, extracting biologically meaningful insights from such high-dimensional, noisy, and sparsely annotated datasets remains a non-trivial task. Recently, LLMs has been applied effectively to predict structural variations in biological sequences. In this work, we explore the potential of fine-tuned LLMs to predict cardiac diseases and SNPs potentially leading to CVD risk using genetic markers derived from high-throughput genomic profiling. We investigate the effect of genetic patterns associated with cardiac conditions and evaluate how LLMs can learn latent biological relationships from structured and semi-structured genomic data obtained by mapping genetic aspects that are inherited from the family tree. By framing the problem as a Chain of Thought (CoT) reasoning task, the models are prompted to generate disease labels and articulate informed clinical deductions across diverse patient profiles and phenotypes. The findings highlight the promise of LLMs in contributing to early detection, risk assessment, and ultimately, the advancement of personalized medicine in cardiac care. Cardiovascular disease (CVDs) remain the most common cause of mortality globally. In 2023, approximately 20.5 million people died from CVDs [1], accounting for about one-third of all global deaths. This marks a significant increase from the estimated 17.9 million CVD deaths in 2019.

The management of chronic Heart Failure (HF) presents significant challenges in modern healthcare, requiring continuous monitoring, early detection of exacerbations, and personalized treatment strategies. In this paper, we present a predictive model founded on Machine Learning (ML) techniques to identify patients at HF risk. This model is an ensemble learning approach, a modified stacking technique, that uses two specialized models leveraging clinical and echocardiographic features and then a meta-model to combine the predictions of these two models. We initially assess the model on a real dataset and the obtained results suggest that it performs well in the stratification of patients at HR risk. Specifically, we obtained high sensitivity (95\%), ensuring that nearly all high-risk patients are identified. As for accuracy, we obtained 84\%, which can be considered moderate in some ML contexts. However, it is acceptable given our priority of identifying patients at risk of HF because they will be asked to participate in the telemonitoring program of the PrediHealth research project on which some of the authors of this paper are working. The initial findings also suggest that ML-based risk stratification models can serve as valuable decision-support tools not only in the PrediHealth project but also for healthcare professionals, aiding in early intervention and personalized patient management. To have a better understanding of the value and of potentiality of our predictive model, we also contrasted its results with those obtained by using three baseline models. The preliminary results indicate that our predictive model outperforms these baselines that flatly consider features, \ie not grouping them in clinical and echocardiographic features.

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.

Background: Patients with both diabetes mellitus (DM) and atrial fibrillation (AF) face elevated mortality in intensive care units (ICUs), yet models targeting this high-risk group remain limited. Objective: To develop an interpretable machine learning (ML) model predicting 28-day mortality in ICU patients with concurrent DM and AF using early-phase clinical data. Methods: A retrospective cohort of 1,535 adult ICU patients with DM and AF was extracted from the MIMIC-IV database. Data preprocessing involved median/mode imputation, z-score normalization, and early temporal feature engineering. A two-step feature selection pipeline-univariate filtering (ANOVA F-test) and Random Forest-based multivariate ranking-yielded 19 interpretable features. Seven ML models were trained with stratified 5-fold cross-validation and SMOTE oversampling. Interpretability was assessed via ablation and Accumulated Local Effects (ALE) analysis. Results: Logistic regression achieved the best performance (AUROC: 0.825; 95% CI: 0.779-0.867), surpassing more complex models. Key predictors included RAS, age, bilirubin, and extubation. ALE plots showed intuitive, non-linear effects such as age-related risk acceleration and bilirubin thresholds. Conclusion: This interpretable ML model offers accurate risk prediction and clinical insights for early ICU triage in patients with DM and AF.