Predicting "Heart Age" Using Electrocardiography
Predicting "Heart Age" Using Electrocardiography
复制标题
DOI：
10.3390/jpm4010065
复制
发表时间：
2014-03-01
影响因子：
--
通讯作者：
Dabney, Alan R.
中科院分区：
文献类型：
--
作者：
Ball, Robyn L.;Feiveson, Alan H.;Dabney, Alan R.
了解患者的心脏年龄，或“心脏年龄”，可以证明对患者和医生都有用，可以更好地鼓励生活方式的改变，这可能对心血管健康有益。这对于表现出症状但心脏病理学检测呈阴性的患者尤其如此。我们开发了一个统计模型，使用贝叶斯方法，预测一个人的心脏年龄的基础上，他/她的心电图（ECG）。该模型专为健康个体量身定制，没有已知的风险因素，年龄至少20岁，并且已获得类似于5分钟12导联心电图的静息心电图。我们使用来自776个这样的个体的ECG数据库来评估该模型。其次，我们还将该模型应用于接受5分钟ECG的其他人群，包括221名具有心脏病风险因素的人，441名通过临床成像测试诊断为明显心脏病的人，以及一小群受过高度训练的运动员。在健康的非运动员中，模型相关的心脏年龄预测倾向于以身体年龄为中心，而大约四分之三的有风险因素的受试者和几乎所有被证实患有心脏病的患者的预测心脏年龄高于真实身体年龄。该模型还预测，在大多数接受过高强度训练的运动员中，心脏年龄比身体年龄稍高，这可能与最近在这些人中发现的可能的纤维化或其他异常一致。
Knowledge of a patient's cardiac age, or "heart age", could prove useful to both patients and physicians for better encouraging lifestyle changes potentially beneficial for cardiovascular health. This may be particularly true for patients who exhibit symptoms but who test negative for cardiac pathology. We developed a statistical model, using a Bayesian approach, that predicts an individual's heart age based on his/her electrocardiogram (ECG). The model is tailored to healthy individuals, with no known risk factors, who are at least 20 years old and for whom a resting similar to 5 min 12-lead ECG has been obtained. We evaluated the model using a database of ECGs from 776 such individuals. Secondarily, we also applied the model to other groups of individuals who had received 5-min ECGs, including 221 with risk factors for cardiac disease, 441 with overt cardiac disease diagnosed by clinical imaging tests, and a smaller group of highly endurance-trained athletes. Model-related heart age predictions in healthy non-athletes tended to center around body age, whereas about three-fourths of the subjects with risk factors and nearly all patients with proven heart diseases had higher predicted heart ages than true body ages. The model also predicted somewhat higher heart ages than body ages in a majority of highly endurance-trained athletes, potentially consistent with possible fibrotic or other anomalies recently noted in such individuals.