TY - JOUR
T1 - Artificial intelligence-derived cardiac ageing is associated with cardiac events post-heart transplantation
AU - Ozcan, Ilke
AU - Toya, Takumi
AU - Cohen-Shelly, Michal
AU - Park, Hyun Woong
AU - Ahmad, Ali
AU - Ozcan, Alp
AU - Noseworthy, Peter A.
AU - Kapa, Suraj
AU - Lerman, Lilach O.
AU - Attia, Zachi I.
AU - Kushwaha, Sudhir S.
AU - Friedman, Paul A.
AU - Lerman, Amir
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Aims: An artificial intelligence algorithm detecting age from 12-lead electrocardiogram (ECG) has been suggested to reflect 'physiological age'. An increased physiological age has been associated with a higher risk of cardiac mortality in the non-transplant population. We aimed to investigate the utility of this algorithm in patients who underwent heart transplantation (HTx). Methods and results: A total of 540 patients were studied. The average ECG ages within 1 year before and after HTx were used to represent pre- and post-HTx ECG ages. Major adverse cardiovascular event (MACE) was defined as any coronary revascularization, heart failure hospitalization, re-transplantation, and mortality. Recipient pre-transplant ECG age (mean 63 ± 11 years) correlated significantly with recipient chronological age (mean 49 ± 14 years, R = 0.63, P < 0.0001), while post-transplant ECG age (mean 54 ± 10 years) correlated with both the donor (mean 32 ± 13 years, R = 0.45, P < 0.0001) and the recipient ages (R = 0.38, P < 0.0001). During a median follow-up of 8.8 years, 307 patients experienced MACE. Patients with an increase in ECG age post-transplant showed an increased risk of MACE [hazard ratio (HR): 1.58, 95% confidence interval (CI): (1.24, 2.01), P = 0.0002], even after adjusting for potential confounders [HR: 1.58, 95% CI: (1.19, 2.10), P = 0.002]. Conclusion: Electrocardiogram age-derived cardiac ageing after transplantation is associated with a higher risk of MACE. This study suggests that physiological age change of the heart might be an important determinant of MACE risk post-HTx.
AB - Aims: An artificial intelligence algorithm detecting age from 12-lead electrocardiogram (ECG) has been suggested to reflect 'physiological age'. An increased physiological age has been associated with a higher risk of cardiac mortality in the non-transplant population. We aimed to investigate the utility of this algorithm in patients who underwent heart transplantation (HTx). Methods and results: A total of 540 patients were studied. The average ECG ages within 1 year before and after HTx were used to represent pre- and post-HTx ECG ages. Major adverse cardiovascular event (MACE) was defined as any coronary revascularization, heart failure hospitalization, re-transplantation, and mortality. Recipient pre-transplant ECG age (mean 63 ± 11 years) correlated significantly with recipient chronological age (mean 49 ± 14 years, R = 0.63, P < 0.0001), while post-transplant ECG age (mean 54 ± 10 years) correlated with both the donor (mean 32 ± 13 years, R = 0.45, P < 0.0001) and the recipient ages (R = 0.38, P < 0.0001). During a median follow-up of 8.8 years, 307 patients experienced MACE. Patients with an increase in ECG age post-transplant showed an increased risk of MACE [hazard ratio (HR): 1.58, 95% confidence interval (CI): (1.24, 2.01), P = 0.0002], even after adjusting for potential confounders [HR: 1.58, 95% CI: (1.19, 2.10), P = 0.002]. Conclusion: Electrocardiogram age-derived cardiac ageing after transplantation is associated with a higher risk of MACE. This study suggests that physiological age change of the heart might be an important determinant of MACE risk post-HTx.
KW - Artificial intelligence
KW - Cardiac allograft vasculopathy
KW - Electrocardiogram
KW - Heart transplantation
UR - http://www.scopus.com/inward/record.url?scp=85153895691&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85153895691&partnerID=8YFLogxK
U2 - 10.1093/ehjdh/ztac051
DO - 10.1093/ehjdh/ztac051
M3 - Article
AN - SCOPUS:85153895691
SN - 2634-3916
VL - 3
SP - 516
EP - 524
JO - European Heart Journal - Digital Health
JF - European Heart Journal - Digital Health
IS - 4
ER -