Key result
Personalized ECG-based AI estimates LVEF with ~6% mean absolute error, outperforming a generalized model.
Why the study?
LVEF is typically assessed using resource-intensive imaging like TTE, prompting evaluation of the easily accessible ECG as an alternative to estimate LVEF.
Can artificial intelligence models using ECG data accurately estimate LVEF and identify LV systolic dysfunction compared to TTE?
Observational (n=191,941)
Can artificial intelligence models using ECG data accurately estimate LVEF and identify LV systolic dysfunction compared to TTE?
Absolute Event Rate: 5.98% vs 8.98%
p-value: p=<0.0001
AI-based analysis of standard ECGs can accurately estimate LVEF and screen for LV systolic dysfunction, offering an accessible alternative to echocardiography.
Left-ventricular (LV) ejection fraction (LVEF) is a fundamental measure of cardiac function, typically assessed with resource-intensive imaging techniques, such as transthoracic echocardiography (TTE). We evaluated the electrocardiogram (ECG) as an alternative, easily accessible data to estimate LVEF in a large cohort of 191,941 patients, comprising 236,623 ECG/TTE pairs. Using either the ECG data alone or with structured features, we developed convolutional and probabilistic neural network models to estimate LVEF and quantify its uncertainty. The ECG-only model achieved a mean-absolute-error (MAE) of 7.71% and a root-mean-square-error (RMSE) of 10.36%, while the hybrid model achieved an MAE of 7.84% and an RMSE of 10.52%. Personalized models significantly improved performance, achieving MAEs of 5.98% (ECG-only) and 6.75% (hybrid). LV systolic dysfunction (LVEF ≤ 40%) was identified with an AUC of 0.88, sensitivity of 0.92 and negative predictive value of 0.98. The presented models demonstrated excellent performance in estimating LVEF and screening of LV systolic dysfunction.
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Thambiraj et al. (2026) conducted an observational in Left ventricular systolic dysfunction (n=191,941). Personalized ECG-based convolutional neural network vs. Generalized ECG-based convolutional neural network was evaluated on Mean absolute error (MAE) of LVEF estimation (p=<0.0001). A personalized artificial intelligence model using electrocardiogram data estimated left ventricular ejection fraction with a mean absolute error of 5.98%, significantly outperforming a generalized model.
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