AI-driven study redefines right heart health assessment with novel predictive model

New York, NY [January 4, 2023]—In a milestone study, researchers from the Icahn School of Medicine at Mount Sinai have harnessed the power of artificial intelligence (AI) to enhance the assessment of the heart’s right ventricle, which sends blood to the lungs. 

Conducted by a team using AI-enabled electrocardiogram (AI-ECG) analysis, the research demonstrates that electrocardiograms can effectively predict right-side heart issues, offering a simpler alternative to complex imaging technologies and potentially enhancing patient outcomes.

The findings were described in the December 29 online issue of Journal of the American Heart Association:https://www.ahajournals.org/doi/10.1161/JAHA.123.031671.

“We aimed to find a better way to assess the health of the heart’s right ventricle, focusing on its ability to pump blood and its size. Traditional methods fall short, which prompted us to explore AI-ECG analysis as a potential solution,” says co-first author Son Q. Duong MD, MS, Assistant Professor of Pediatrics (Pediatric Cardiology) at Icahn Mount Sinai. “This novel method could expedite the identification of heart problems, especially in the right ventricle, and potentially lead to earlier and more effective treatment. It holds particular importance for patients with congenital heart disease, who often face issues in the right ventricle.”

The study trained a deep-learning ECG (DL-ECG) model using harmonized data from 12-lead ECGs and cardiac magnetic resonance imaging (MRI) measurements. It was conducted on a large sample from the UK Biobank and validated at multiple health centers across the Mount Sinai Health System, measuring its accuracy in predicting heart conditions and its impact on patient survival rates.

“This innovative approach departs significantly from traditional methods. Unlike other studies, this research predicts something not easily quantifiable by other common tests, such as the heart ultrasound,” says co-first author Akhil Vaid, MD, Clinical Instructor of Medicine (Data-Driven and Digital Medicine) at Icahn Mount Sinai. 

The investigators say that while the use of artificial intelligence allows for more precise heart information from commonly available tools, it's in an early stage and doesn't replace advanced diagnostics. Further work is needed to ensure the tool's safety and correct applicability.

In addition, the study's predictions may vary across populations, relying on existing ECG and MRI data with inherent limitations. Its application in everyday clinical practice requires further exploration, cautioned the researchers.

“Our findings mark a significant leap forward in right heart health assessment, offering a glimpse into a future where AI plays a pivotal role in early and accurate diagnosis. The study stands out for applying AI to standard ECG data, predicting right ventricular function and size numerically,” says senior author Girish Nadkarni, MD, MPH, Irene and Dr. Arthur M. Fishberg Professor of Medicine at Icahn Mount Sinai, Director of The Charles Bronfman Institute of Personalized Medicine, and System Chief of Data-Driven and Digital Medicine.

Future research plans include external validation of the DL-ECG models in diverse populations, ensuring broader applicability and confirming clinical usefulness in conditions like pulmonary hypertension, congenital heart disease, and various forms of cardiomyopathy.

The paper is titled “Quantitative prediction of right ventricular size and function from the electrocardiogram.”

This study was supported by the National Heart, Lung, and Blood Institute, National Institutes of Health (R01HL155915), and National Center for Advancing Translational Sciences, National Institutes of Health (CTSA grant UL1TR004419). Please see https://www.ahajournals.org/doi/10.1161/JAHA.123.031671 to view competing interests.

The remaining authors, all with Icahn Mount Sinai except where indicated, are Vy Thi Ha My, PhD; Liam R. Butler, BS; Joshua Lampert, MD; Robert H. Pass, MD; Alexander W. Charney, MD, PhD; Jagat Narula, MD, PhD; Rohan Khera, MD, MS (Yale School of Medicine, Yale School of Public Health, Yale-New Haven Hospital); Ankit Sakhuja, MBBS, MS; Hayit Greenspan, PhD; Bruce D. Gelb, MD; and Ron Do, PhD.

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About the Icahn School of Medicine at Mount Sinai

The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the eight- member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to a large and diverse patient population.  

Ranked 14th nationwide in National Institutes of Health (NIH) funding and among the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges, Icahn Mount Sinai has a talented, productive, and successful faculty. More than 3,000 full-time scientists, educators, and clinicians work within and across 44 academic departments and 36 multidisciplinary institutes, a structure that facilitates tremendous collaboration and synergy. Our emphasis on translational research and therapeutics is evident in such diverse areas as genomics/big data, virology, neuroscience, cardiology, geriatrics, as well as gastrointestinal and liver diseases. 

Icahn Mount Sinai offers highly competitive MD, PhD, and Master’s degree programs, with current enrollment of approximately 1,300 students. It has the largest graduate medical education program in the country, with more than 2,000 clinical residents and fellows training throughout the Health System. In addition, more than 550 postdoctoral research fellows are in training within the Health System. 

A culture of innovation and discovery permeates every Icahn Mount Sinai program. Mount Sinai’s technology transfer office, one of the largest in the country, partners with faculty and trainees to pursue optimal commercialization of intellectual property to ensure that Mount Sinai discoveries and innovations translate into healthcare products and services that benefit the public.

Icahn Mount Sinai’s commitment to breakthrough science and clinical care is enhanced by academic affiliations that supplement and complement the School’s programs.

Through the Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai. Additionally, MSIP develops research partnerships with industry leaders such as Merck & Co., AstraZeneca, Novo Nordisk, and others.

The Icahn School of Medicine at Mount Sinai is located in New York City on the border between the Upper East Side and East Harlem, and classroom teaching takes place on a campus facing Central Park. Icahn Mount Sinai’s location offers many opportunities to interact with and care for diverse communities. Learning extends well beyond the borders of our physical campus, to the eight hospitals of the Mount Sinai Health System, our academic affiliates, and globally.

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* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Beth Israel; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.