{"doi":"10.1016/j.jacadv.2023.100446","title":"Identifying Mitral Valve Prolapse at Risk for Arrhythmias and Fibrosis From Electrocardiograms Using Deep Learning","abstract":"Mitral valve prolapse (MVP) is a common valvulopathy, with a subset developing sudden cardiac death or cardiac arrest. Complex ventricular ectopy (ComVE) is a marker of arrhythmic risk associated with myocardial fibrosis and increased mortality in MVP. The authors sought to evaluate whether electrocardiogram (ECG)-based machine learning can identify MVP at risk for ComVE, death and/or myocardial fibrosis on cardiac magnetic resonance (CMR) imaging. A deep convolutional neural network (CNN) was trained to detect ComVE using 6,916 12-lead ECGs from 569 MVP patients from the University of California-San Francisco between 2012 and 2020. A separate CNN was trained to detect late gadolinium enhancement (LGE) using 1,369 ECGs from 87 MVP patients with contrast CMR. The prevalence of ComVE was 28% (160/569). The area under the receiver operating characteristic curve (AUC) of the CNN to detect ComVE was 0.80 (95% CI: 0.77-0.83) and remained high after excluding patients with moderate-severe mitral regurgitation [0.80 (95% CI: 0.77-0.83)] or bileaflet MVP [0.81 (95% CI: 0.76-0.85)]. AUC to detect all-cause mortality was 0.82 (95% CI: 0.77-0.87). ECG segments relevant to ComVE prediction were related to ventricular depolarization/repolarization (early-mid ST-segment and QRS from V1, V3, and III). LGE in the papillary muscles or basal inferolateral wall was present in 24% patients with available CMR; AUC for detection of LGE was 0.75 (95% CI: 0.68-0.82). CNN-analyzed 12-lead ECGs can detect MVP at risk for ventricular arrhythmias, death and/or fibrosis and can identify novel ECG correlates of arrhythmic risk. ECG-based CNNs may help select those MVP patients requiring closer follow-up and/or a CMR.","journal":"JACC Advances","year":2023,"id":334743,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9591,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":63393,"name":"SEAN ABREAU","orcid":"0000-0002-9426-3789","position":1,"is_corresponding":false},{"id":63396,"name":"JOSHUA BARRIOS","orcid":"0000-0003-1618-6244","position":2,"is_corresponding":false},{"id":585876,"name":"Lisa J. Lim","orcid":"0000-0002-8666-2843","position":3,"is_corresponding":false},{"id":1023888,"name":"Michelle Yang","orcid":"0009-0002-8680-5725","position":4,"is_corresponding":false},{"id":1063600,"name":"Valentina Crudo","orcid":"0000-0002-2465-8830","position":5,"is_corresponding":false},{"id":345237,"name":"Dipan J. Shah","orcid":"0000-0002-6179-2393","position":6,"is_corresponding":false},{"id":308850,"name":"Thuy Nguyen","orcid":"0000-0001-8879-7090","position":7,"is_corresponding":false},{"id":1063601,"name":"Gene Hu","orcid":"0000-0002-7392-8331","position":8,"is_corresponding":false},{"id":1064162,"name":"Shalini Dixit","orcid":null,"position":9,"is_corresponding":false},{"id":273264,"name":"Gregory Nah","orcid":null,"position":10,"is_corresponding":false},{"id":1064163,"name":"Farzin Arya","orcid":null,"position":11,"is_corresponding":false},{"id":1053489,"name":"Dwight Bibby","orcid":null,"position":12,"is_corresponding":false},{"id":386184,"name":"Yoojin Lee","orcid":"0000-0003-2475-5857","position":13,"is_corresponding":false},{"id":98913,"name":"Francesca N. Delling","orcid":"0000-0002-5224-4096","position":14,"is_corresponding":false},{"id":63402,"name":"GEOFFREY H. TISON","orcid":"0000-0002-0310-3326","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T01:09:53.742667Z","pmid":"37936601","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}