Research highlights:
- An artificial intelligence-enabled digital stethoscope could be an easy and effective way to diagnose cardiac dysfunction during and immediately after pregnancy.
- The stethoscope records electrocardiograms and heart sounds and uses an AI algorithm to predict possible heart muscle weakness.
- AI-guided screening using a digital stethoscope identified twice as many cases of pregnancy-related cardiomyopathy among Nigerian women compared to standard clinical care.
Embargoed until Monday, November 13, 2023 at 9:45 a.m. ET
PHILADELPHIA, November 13, 2023 — Electrocardiogram (EKG)-based screening using an artificial intelligence-enabled digital stethoscope can detect peripartum cardiomyopathy, a disease of the heart muscle in pregnant and newly pregnant women. It can be detected at twice the rate of standard obstetric care, including clinical.Latest science on electrocardiograms presented today at American Heart Association Academic Session 2023. The conference, to be held in Philadelphia from November 11-13, is the premier forum for the global exchange of updates on the latest scientific advances, research, and evidence-based clinical practices in cardiovascular science. .
A study of approximately 1,200 Nigerian women who were pregnant or had just given birth found that ECG testing with a digital stethoscope using an AI algorithm compared to using a clinical ECG in addition to a routine ECG. When conducted, peripartum cardiomyopathy was twice as detected among study participants. obstetric care.
“We demonstrate for the first time in an obstetric population that AI-guided screening using a digital stethoscope improves the diagnosis of this potentially life-threatening and treatable condition,” said lead author of the study. said Demilade A. Adiinsewo, MD, MPH, assistant professor. He received his MD in Cardiology from the Mayo Clinic in Jacksonville, Florida.
“This study shifts current clinical practice from being reactive and symptom-driven to a more proactive approach that uses simple, low-cost, and effective screening tools to identify pregnancy-related cardiac dysfunction.” You can change your approach,” she said. “Early diagnosis facilitates prompt and appropriate management of cardiomyopathy, reducing associated morbidity and mortality.”
Peripartum cardiomyopathy is a type of heart failure that can affect women during or after pregnancy. This disease weakens the heart, which reduces the amount of blood it pumps to other parts of the body. Usually diagnosed near the end of pregnancy or a few months after pregnancy, it can be difficult for medical professionals to detect because many of the symptoms, such as shortness of breath and swollen legs, are similar to those seen in a normal pregnancy. There may be cases. According to the American Heart Association.
The incidence of peripartum cardiomyopathy is somewhat low in the United States, affecting one in every 1,000 to 4,000 pregnancies, according to the association. Adedinsewo said it is more prevalent in Nigeria, where the incidence of peripartum cardiomyopathy is reported to be the highest in the world, affecting as many as 1 in 96 pregnancies.
The AI screening included a digital stethoscope that records the heart’s electrical activity and records heart sounds. Women in the AI intervention group also underwent study-specified echocardiography upon study enrollment to verify the effectiveness of the AI algorithm in this group. The AI-enabled stethoscope uses an algorithm originally developed using 12-lead ECG data and modified for use with single-lead ECGs recorded with digital stethoscopes to detect possible left ventricular dysfunction. You can now predict gender. Participants in the control group underwent a traditional electrocardiogram test without the use of an AI-assisted digital stethoscope, and the results were evaluated by a medical professional.
An echocardiogram was used to measure the left ventricular ejection fraction, which measures the heart’s pumping ability. The normal ejection fraction level of the heart is between 55% and 70%. In this study, a left ventricular ejection fraction of less than 50% was the criterion used to diagnose cardiomyopathy.
The study enrolled more than 1,000 Nigerian women who were pregnant or had given birth within the past 12 months between August 2022 and September 2023.
The research found the following:
- Pregnancy-related cardiomyopathy was detected in 4% of pregnant and postpartum women in the group screened with an AI-enabled digital stethoscope.
- The detection rate of cardiomyopathy in the control group was 1.8%, suggesting that half of the cases of cardiomyopathy likely go undetected with usual care.
“We expected that AI-guided screening would improve the diagnosis of cardiomyopathy, but we did not expect that it would double the frequency of cardiomyopathy diagnoses,” said Adedinsewo. “Additional large-scale trials enrolling diverse groups of women in other regions are needed to assess the impact of AI-guided screening on the diagnosis of cardiomyopathy and its impact on adverse maternal outcomes.”
Background and research details:
- A total of 1,195 women between the ages of 18 and 49 were enrolled in the study and completed the required baseline tests. Approximately 73% were pregnant at the start of the study. 39% were in the third trimester of pregnancy.
- Study participants were enrolled from six teaching hospitals in Nigeria.
- Women were randomly assigned, with 587 in the AI-assisted intervention group and 608 in the control group.
According to the American Heart Association, heart disease is the leading cause of death for new mothers in the United States. There is a maternal health crisis in the United States, and the Association of Black Cardiologists, American College of Cardiology, and American Heart Association issued a joint statement in 2023. “Nature’s first cardiac stress test” for pregnant women – provides a window into your future cardiovascular health.
The cause of peripartum cardiomyopathy is still unknown, but with treatment, many affected patients return to normal heart function. But for some people, it can lead to more severe heart failure, so early detection and treatment is important, the American Heart Association says.
Limitations of this study include that the observed rates of cardiomyopathy among study women enrolled in a teaching hospital may not reflect the frequency of cardiomyopathy in the general obstetric population in Nigeria. Can be mentioned. Furthermore, the cutoff value chosen for cardiomyopathy detection in this study was her left ventricular ejection fraction less than 50%. However, this differs from the original training goal (less than 40%) for the AI algorithm adapted for use in digital stethoscopes. The authors observed that ejection fraction detection was improved in her <40% compared with her <50%. AHA guidelines define heart failure as a decrease in ejection fraction of less than 40%.
Co-authors, disclosures, and funding sources are listed in the abstract.
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