Cardiac age detected by machine learning applied to the surface ECG of
healthy subjects: Creation of a benchmark
Abstract
Objective The aim of the present study was to develop a neural network
to characterize the effect of aging on the ECG in healthy volunteers.
Moreover, the impact of the various ECG features on aging was evaluated.
Methods & Results A total of 6228 healthy subjects without structural
heart disease were included in this study. A neural network regression
model was created to predict age of the subjects based on their ECG; 577
parameters derived from a 12-lead ECG of each subject were used to
develop and validate the neural network; A ten fold cross-validation was
performed, using 118 subjects for validation eacht fold. Using SHapley
Additive exPlanations values the impact of the individual features on
the prediction of age was determined. Of 6228 subjects tested, 1808
(29%) were females and mean age was 34 years, range 18 – 75 years.
Physiologic age was estimated as a continuous variable with an average
error of 6.9±5.6 years (R2= 0.72 ± 0.04) . The correlation was slightly
stronger for men (R2= 0.74) than for women (R2= 0.66). The most
important features on the prediction of physiologic age were T wave
morphology indices in leads V4 and V5, and P wave amplitude in leads AVR
and II. Conclusion The application of artificial intelligence to the ECG
using a neural network regression model, allows accurate estimation of
physiologic cardiac age. This technique could be used to pick up subtle
age-related cardiac changes, but also estimate the reversing of these
age-associated effects by administered treatments.