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May 8, 2026European Stroke Journal0 citationsOpen Access

Abstract Number: Esoc2026a549 Electrocardiogram and Brain Mri Allow Individualized Estimation of Stroke Risk. A Mulitmodal Deep Learning Analysis

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JDJulian DeseöUniversity of ZurichEREzequiel de la RosaUniversity of ZurichBMBjoern MenzeUniversity of Zurich

Key Result

A multimodal deep-learning model combining brain MRI and ECG improved detection of cardiovascular risk factors and stratified stroke risk over a median 4.8-year follow-up in 69,105 participants.

Key Points

  • The aim is to identify cardiovascular risk factors and their contribution to stroke risk using ECG and MRI data through deep learning.
  • Trained deep-learning models on 23,671 participants from the UK Biobank to identify cardiovascular risk factors like hypertension and atrial fibrillation.
  • Utilized separate models for T2 FLAIR Brain MRI and ECG, then combined them for a comprehensive analysis.
  • Evaluated model performance on an independent test set of 45,434 participants over a median follow-up of 4.8 years.
  • The multimodal model demonstrated the best performance in identifying cardiovascular risk factors.
  • Predicted cardiovascular risk factors facilitated effective risk stratification for incident stroke.
  • Performance metrics included ROC-AUC scores that indicated improved detection capabilities.

Study Design

Type

Cohort (n=69,105)

Multicenter

Yes

Structured PICO

Does a multimodal deep-learning model combining ECG and brain MRI improve the detection of cardiovascular risk factors and stroke risk stratification in a population-based cohort?

P
Population
69,105 participants from the population-based UK Biobank (UKBB) cohort (23,671 in the training set, 45,434 in the test set)
I
Intervention
Multimodal deep-learning analysis combining electrocardiogram (ECG) and T2 FLAIR Brain MRI
C
Comparator
Single modality deep-learning models (ECG alone or Brain MRI alone)
O
Outcome
Identification of cardiovascular risk factors (hypertension, atrial fibrillation, diabetes, and dyslipidemia) and association of predicted risk factors with incident strokesurrogate

A multimodal deep-learning model combining ECG and brain MRI improves the detection of cardiovascular risk factors and enhances stroke risk stratification.

Abstract

Abstract Background and aims Identification of cardiovascular risk factors (CVRF) is essential for targeted prevention of stroke. CVRF affect both the heart and the brain. We aimed to identify CVRF and their contribution to stroke risk by analysing electrocardiogram (ECG) and brain magnetic resonance imaging (MRI) using multimodal deep-learning. Methods We trained two deep-learning models on 23’671 participants in the population-based UK Biobank (UKBB) cohort to identify participants with hypertension, atrial fibrillation, diabetes and dyslipidemia. One model is based on T2 FLAIR Brain MRI, the other is based on ECG. We then combined the models. We evaluated our models on a separate test set from the UKBB (n=45’434). Finally, we investigated if the predicted CVRF were associated with incident stroke over a median follow-up of 4.8 years. Results The multimodal model showed best performance for identifying CVRF (Table 1). The predicted CVRF allowed risk stratification for stroke (Figure 1). Table 1. ROC-AUC for detecting CVRF from T2 FLAIR Brain MRI, ECG and combination of modalities. Figure 1. Cumulative incidence of stroke stratified by number of CVRF predicted by ECG and Brain MRI deep learning models Conclusions Multimodal deep-learning of Brain MRI and ECG allows improved detection of CVRF and risk stratification for stroke. Our models could inform prevention strategies, through identification of CVRF for targeted reduction of stroke risk. Conflict of interest Julian Deseoe: nothing to disclose, Ezequiel de la Rosa: nothing to disclose, Bjoern Menze: nothing to disclose, Susanne Wegener: nothing to disclose Table 1 - belongs to Results Figure 1 - belongs to Conclusions

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Cite This Study

Deseö et al. (2026) conducted a cohort in Stroke risk and cardiovascular risk factors (n=69,105). Multimodal deep-learning model (ECG and Brain MRI) vs. Single modality models (ECG alone or Brain MRI alone) was evaluated on Identification of cardiovascular risk factors and incident stroke. A multimodal deep-learning model combining brain MRI and ECG improved detection of cardiovascular risk factors and stratified stroke risk over a median 4.8-year follow-up in 69,105 participants.

synapsesocial.com/papers/69fd7f65bfa21ec5bbf07dafhttps://doi.org/10.1093/esj/aakag023.341
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