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Artificial intelligence-derived electrocardiographic aging and risk of atrial fibrillation: a multi-national study. 人工智能衍生的心电图老化和房颤风险:一项多国研究。
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae790
Seunghoon Cho, Sujeong Eom, Daehoon Kim, Tae-Hoon Kim, Jae-Sun Uhm, Hui-Nam Pak, Moon-Hyoung Lee, Pil-Sung Yang, Eunjung Lee, Zachi Itzhak Attia, Paul Andrew Friedman, Seng Chan You, Hee Tae Yu, Boyoung Joung

Background and aims: Artificial intelligence (AI) algorithms in 12-lead electrocardiogram (ECG) provides promising age prediction methods. This study investigated whether the discrepancy between ECG-derived AI-predicted age (AI-ECG age) and chronological age, termed electrocardiographic aging (ECG aging), is associated with atrial fibrillation (AF) risk.

Methods: An AI-ECG age prediction model was developed using a large-scale dataset (1 533 042 ECGs from 689 639 participants) and validated with six independent and multi-national datasets (737 133 ECGs from 330 794 participants). The AI-ECG age gap was calculated across two South Korean cohorts [mean (standard deviation) follow-up: 4.1 (4.3) years for 111 483 participants and 6.1 (3.8) years for 37 517 participants], one UK cohort [3.0 (1.6) years; 40 973 participants], and one US cohort [12.9 (8.6) years; 90 639 participants]. Participants were classified into two groups: normal group (age gap < 7 years) and ECG-aged group (age gap ≥ 7 years). The predictive capability of ECG aging for new- and early-onset AF risk was assessed.

Results: The mean AI-ECG ages were 51.9 (16.2), 47.4 (12.5), 68.4 (7.8), and 56.7 (14.6) years with age gaps of .0 (6.8), -.1 (6.0), 4.7 (8.7), and -1.4 (8.9) years in the two South Korean, UK, and US cohorts, respectively. In the ECG-aged group, increased risks of new-onset AF were observed with hazard ratios (95% confidence intervals) of 2.50 (2.24-2.78), 1.89 (1.46-2.43), 1.90 (1.55-2.33), and 1.76 (1.67-1.86) in the two South Korean, UK, and US cohorts, respectively. For early-onset AF, odds ratios were 2.89 (2.47-3.37), 1.94 (1.39-2.70), 1.58 (1.06-2.35), and 1.79 (1.62-1.97) in these cohorts compared with the normal group.

Conclusions: The AI-derived ECG aging was associated with the risk of new- and early-onset AF, suggesting its potential utility to identify individuals for AF prevention across diverse populations.

背景与目的:人工智能(AI)算法在12导联心电图(ECG)中的应用为年龄预测提供了很有前景的方法。本研究调查了心电图预测年龄(AI-ECG年龄)与实足年龄之间的差异,即心电图老化(ECG老化)是否与房颤(AF)风险相关。方法:使用大规模数据集(来自689 639名参与者的1 533 042张心电图)建立AI-ECG年龄预测模型,并使用6个独立的跨国数据集(来自330 794名参与者的737 133张心电图)进行验证。计算了两个韩国队列的AI-ECG年龄差距[平均(标准差)随访:111 483名参与者4.1(4.3)年,37 517名参与者6.1(3.8)年],一个英国队列[3.0(1.6)年;40973名参与者]和一个美国队列[12.9(8.6)岁;90639人]。参与者分为正常组(年龄差距< 7岁)和心电图组(年龄差距≥7岁)。评估心电图老化对新发和早发房颤风险的预测能力。结果:患者AI-ECG平均年龄分别为51.9(16.2)、47.4(12.5)、68.4(7.8)、56.7(14.6)岁,年龄差距分别为0(6.8)、- 0.1在韩国、英国和美国的两个队列中分别为(6.0)、4.7(8.7)和-1.4(8.9)年。在心电图年龄组中,观察到新发房颤的风险增加,在韩国、英国和美国两个队列中,风险比(95%置信区间)分别为2.50(2.24-2.78)、1.89(1.46-2.43)、1.90(1.55-2.33)和1.76(1.67-1.86)。与正常组相比,早发性房颤的比值比分别为2.89(2.47-3.37)、1.94(1.39-2.70)、1.58(1.06-2.35)和1.79(1.62-1.97)。结论:人工智能得出的心电图老化与新发和早发房颤的风险相关,表明其在不同人群中识别房颤预防个体的潜在效用。
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引用次数: 0
Targeted approach for next-generation coronary stents.
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehaf007
Simon D Brown, Julie Rodor, Andrew H Baker
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引用次数: 0
Non-traditional risk factors and artificial intelligence in the management of atrial fibrillation.
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehaf028
Filippo Crea
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引用次数: 0
Non-traditional risk factors for atrial fibrillation: epidemiology, mechanisms, and strategies. 房颤的非传统危险因素:流行病学、机制和策略。
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae887
Yingli Lu, Ying Sun, Lingli Cai, Bowei Yu, Yuying Wang, Xiao Tan, Heng Wan, Dachun Xu, Junfeng Zhang, Lu Qi, Prashanthan Sanders, Ningjian Wang

Atrial fibrillation (AF) has become the pre-dominant arrhythmia worldwide and is associated with high morbidity and mortality. Its pathogenesis is intricately linked to the deleterious impact of cardiovascular risk factors, emphasizing the pivotal imperative for early detection and mitigation strategies targeting these factors for the prevention of primary AF. While traditional risk factors are well recognized, an increasing number of novel risk factors have been identified in recent decades. This review explores the emerging non-traditional risk factors for the primary prevention of AF, including unhealthy lifestyle factors in current society (sleep, night shift work, and diet), biomarkers (gut microbiota, hyperuricaemia, and homocysteine), adverse conditions or diseases (depression, epilepsy, clonal haematopoiesis of indeterminate potential, infections, and asthma), and environmental factors (acoustic pollution and other environmental factors). Unlike traditional risk factors, individuals have limited control over many of these non-traditional risk factors, posing challenges to conventional prevention strategies. The purpose of this review is to outline the current evidence on the associations of non-traditional risk factors with new-onset AF and the potential mechanisms related to these risk factors. Furthermore, this review aims to explore potential interventions targeting these risk factors at both the individual and societal levels to mitigate the growing burden of AF, suggesting guideline updates for primary AF prevention.

心房颤动(AF)已成为世界范围内主要的心律失常,具有较高的发病率和死亡率。其发病机制与心血管危险因素的有害影响错综复杂,强调了针对这些因素的早期发现和缓解策略对于预防原发性房颤的关键必要性。虽然传统的危险因素得到了很好的认识,但近几十年来发现了越来越多的新危险因素。本综述探讨了新出现的非传传式AF一级预防的危险因素,包括当前社会中不健康的生活方式因素(睡眠、夜班工作和饮食)、生物标志物(肠道微生物群、高尿酸血症和同型半胱氨酸)、不良条件或疾病(抑郁、癫痫、潜在克隆性造血不确定、感染和哮喘)和环境因素(声污染和其他环境因素)。与传统的风险因素不同,个人对这些非传统风险因素的控制有限,对传统的预防策略构成挑战。本综述的目的是概述非传统危险因素与新发房颤相关的现有证据以及与这些危险因素相关的潜在机制。此外,本综述旨在探讨在个人和社会层面针对这些危险因素的潜在干预措施,以减轻房颤日益增加的负担,并建议更新原发性房颤预防指南。
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引用次数: 0
Rate dependent complete right bundle block: a challenging diagnosis in Brugada syndrome. 速率依赖的完全右束阻滞:Brugada综合征的一个具有挑战性的诊断。
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae921
Jing Yang, Rong He, Ping Zhang
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引用次数: 0
Exercise prescription in hypertrophic cardiomyopathy: Dr Lown's lesson to break taboos.
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae659
Iacopo Olivotto, Flavio D'Ascenzi
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引用次数: 0
Artificial intelligence and digital tools for design and execution of cardiovascular clinical trials. 设计和执行心血管临床试验的人工智能和数字工具。
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae794
Jiun-Ruey Hu, John R Power, Faiez Zannad, Carolyn S P Lam

Recent advances have given rise to a spectrum of digital health technologies that have the potential to revolutionize the design and conduct of cardiovascular clinical trials. Advances in domain tasks such as automated diagnosis and classification, synthesis of high-volume data and latent data from adjacent modalities, patient discovery, telemedicine, remote monitoring, augmented reality, and in silico modelling have the potential to enhance the efficiency, accuracy, and cost-effectiveness of cardiovascular clinical trials. However, early experience with these tools has also exposed important issues, including regulatory barriers, clinical validation and acceptance, technological literacy, integration with care models, and health equity concerns. This narrative review summarizes the landscape of digital tools at each stage of clinical trial planning and execution and outlines roadblocks and opportunities for successful implementation of digital tools in cardiovascular clinical trials.

最近的进展已经产生了一系列数字卫生技术,这些技术有可能彻底改变心血管临床试验的设计和实施。领域任务的进步,如自动诊断和分类、大量数据和邻近模式潜在数据的合成、患者发现、远程医疗、远程监测、增强现实和计算机建模,有可能提高心血管临床试验的效率、准确性和成本效益。然而,这些工具的早期经验也暴露了一些重要问题,包括监管障碍、临床验证和接受、技术素养、与护理模式的整合以及卫生公平问题。这篇叙述性综述总结了临床试验计划和执行的每个阶段的数字工具的前景,并概述了在心血管临床试验中成功实施数字工具的障碍和机会。
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引用次数: 0
Malignant pheochromocytoma associated with pulmonary hypertension. 伴有肺动脉高压的恶性嗜铬细胞瘤。
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae842
Dili Xie, Xuechun Sun, Yunshan Cao
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引用次数: 0
Artificial intelligence in patients with atrial fibrillation to manage clinical complexity and comorbidities: the ARISTOTELES project. 人工智能心房颤动患者管理临床复杂性和合并症:ARISTOTELES项目。
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae792
Giuseppe Boriani, Davide Antonio Mei, Gregory Y H Lip
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引用次数: 0
Weekly Journal Scan: The jury is still out on beta-blockers following acute myocardial infarction with preserved ejection fraction after the ABYSS trial. 每周期刊扫描:ABYSS试验后,射血分数保留的急性心肌梗死患者使用β-受体阻滞剂的前景仍不明朗。
IF 37.6 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-03-03 DOI: 10.1093/eurheartj/ehae858
Daniela Pedicino, Massimo Volpe
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引用次数: 0
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European Heart Journal
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