Machine learning models predicted progression to severe aortic stenosis within 2 and 5 years with an AUC of 0.86, and all-cause mortality with AUCs of 0.84 and 0.87.
Cohort (n=9,611)
Yes
Can machine learning models accurately predict the risk of disease progression and mortality in patients with mild aortic valve stenosis?
Machine learning models using routine clinical and echocardiographic data can accurately predict disease progression and mortality in patients with mild aortic stenosis, potentially facilitating personalized follow-up.
Effect estimate: AUC 0.86 for progression; AUC 0.84-0.87 for mortality
Aims: Aortic stenosis (AS) is a common and progressive disease, which, if left untreated, results in increased morbidity and mortality. Monitoring and follow-up care can be challenging due to significant variability in disease progression. This study aimed to develop machine learning models to predict the risks of disease progression and mortality in patients with mild AS. Methods and results: A comprehensive database including 9611 patients with serial transthoracic echocardiograms was collected from a single institution across three clinical sites. The data set included parameters from echocardiograms, electrocardiograms, laboratory values, and diagnosis codes. Data from a single clinical site were preserved as an independent test group. Machine learning models were trained to identify progression to severe stenosis and all-cause mortality and tested in their performance for endpoints at 2 and 5 years. In the independent test group, the AS progression model differentiated those with progression to severe AS within 2 and 5 years with an area under the curve (AUC) of 0.86 for both. The feature of greatest importance was aortic valve mean gradient, followed by other valve haemodynamic measurements including valve area and dimensionless index. The mortality model identified those with mortality within 2 and 5 years with an AUC of 0.84 and 0.87, respectively. Smaller reduced-input validation models had similarly robust findings. Conclusion: Machine learning models can be used in patients with mild AS to identify those at high risk of disease progression and mortality. Implementation of such models may facilitate real-time, patient-specific follow-up recommendations.
Julakanti et al. (Mon,) conducted a cohort in Mild aortic valve stenosis (n=9,611). Machine learning models was evaluated on Progression to severe stenosis and all-cause mortality at 2 and 5 years (AUC 0.86 for progression; AUC 0.84-0.87 for mortality). Machine learning models predicted progression to severe aortic stenosis within 2 and 5 years with an AUC of 0.86, and all-cause mortality with AUCs of 0.84 and 0.87.