共找到 20 条结果
暂无摘要（点击查看详情）
Cardiovascular-Kidney-Metabolic (CKM) syndrome represents a growing public health crisis, yet the subclinical heterogeneity of its component systems remains underexplored. Early detection of physiological deviation is critical for preventing irreversible organ damage and mortality. Here, we characterize the prevalence and interplay of CKM impairment in a US cohort (N=841) by integrating continuous wearable data with clinical biomarkers. We assessed cardiovascular, kidney via clinical biomarkers, namely Chol/HDL, eGFR, as well as metabolic health risk through Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). We show that while metabolic and cardiovascular disruptions are significantly associated (r=0.26, p<0.001), early-stage kidney impairment manifests independently. Utilizing a normalized deviance score, we identified significant health impairments in 29.0% of the cohort. Cardiovascular deviation was the most prevalent singular phenotype (13.3%), followed by metabolic (9.1%) and renal (6.25%) deviations, with dual metabolic-cardiovascular impairment occurring in only 2.2% of participants. These findings suggest that high system-specific deviance may serve as an indi
We present ASCENDgpt, a transformer-based model specifically designed for cardiovascular risk prediction from longitudinal electronic health records (EHRs). Our approach introduces a novel phenotype-aware tokenization scheme that maps 47,155 raw ICD codes to 176 clinically meaningful phenotype tokens, achieving 99.6\% consolidation of diagnosis codes while preserving semantic information. This phenotype mapping contributes to a total vocabulary of 10,442 tokens - a 77.9\% reduction when compared with using raw ICD codes directly. We pretrain ASCENDgpt on sequences derived from 19402 unique individuals using a masked language modeling objective, then fine-tune for time-to-event prediction of five cardiovascular outcomes: myocardial infarction (MI), stroke, major adverse cardiovascular events (MACE), cardiovascular death, and all-cause mortality. Our model achieves excellent discrimination on the held-out test set with an average C-index of 0.816, demonstrating strong performance across all outcomes (MI: 0.792, stroke: 0.824, MACE: 0.800, cardiovascular death: 0.842, all-cause mortality: 0.824). The phenotype-based approach enables clinically interpretable predictions while maintaini
The cardiovascular and ocular systems are intricately connected, with hemodynamic interactions playing a crucial role in both physiological regulation and pathological conditions. However, existing models often treat these systems separately, limiting the understanding of their interdependence. In this study, we present the Eye2Heart model, a novel closed-loop mathematical framework that integrates cardiovascular and ocular dynamics. Using an electricalhydraulic analogy, the model describes the interactions between the heart and retinal circulation through a system of ordinary differential equations. The model is validated against clinical and experimental data, demonstrating its ability to reproduce key cardiovascular parameters (e.g., stroke volume, cardiac output) and ocular hemodynamics (e.g., retinal blood flow). Additionally, we explore in silico the effects of intraocular pressure (IOP) and left ventricular compliance on both local ocular and global systemic circulation, revealing critical dependencies between cardiovascular and ocular health. The results highlight the model's potential for studying cardiovascular diseases with ocular manifestations, paving the way for patie
Women are underdiagnosed and undertreated for cardiovascular disease. Automatic quantification of breast arterial calcification on screening mammography can identify women at risk for cardiovascular disease and enable earlier treatment and management of disease. In this retrospective study of 116,135 women from two healthcare systems, a transformer-based neural network quantified BAC severity (no BAC, mild, moderate, and severe) on screening mammograms. Outcomes included major adverse cardiovascular events (MACE) and all-cause mortality. BAC severity was independently associated with MACE after adjusting for cardiovascular risk factors, with increasing hazard ratios from mild (HR 1.18-1.22), moderate (HR 1.38-1.47), to severe BAC (HR 2.03-2.22) across datasets (all p<0.001). This association remained significant across all age groups, with even mild BAC indicating increased risk in women under 50. BAC remained an independent predictor when analyzed alongside ASCVD risk scores, showing significant associations with myocardial infarction, stroke, heart failure, and mortality (all p<0.005). Automated BAC quantification enables opportunistic cardiovascular risk assessment during
The vascular network in the human body is characterized by blood vessels exhibiting drastic structural variations in radius, length, topological properties, and branching patterns. This heterogeneity, together with location-specific anatomical background variations, poses a significant challenge for robust, large-scale analysis of the entire cardiovascular system. As a result, most research has focused on narrow, isolated segments of the vascular network. While such targeted studies provide valuable insights, they inherently limit the ability to assess the systemic health and functional integrity of the vascular network as a whole. In this work, we aim to bridge this gap to advance both clinical diagnostics and our fundamental understanding of vascular physiology. We propose the task of segmenting all vessels in CT images, ranging from the largest components of the cardiovascular system to even minuscule mesenteric vessels. To this end, we introduce vesselFM-CT, the first model capable of robustly segmenting all blood vessels in 3D CT images. VesselFM-CT is trained via an iterative, multi-step process and optimizes our proposed TubeLoss loss function, effectively addressing the inh
Zero-dimensional cardiovascular models provide a computationally efficient framework for studying global hemodynamic behavior, yet the influence of model complexity on parameter sensitivity remains insufficiently understood. This work investigates two lumped-parameter cardiovascular models, a simplified single-ventricle configuration and a detailed four-chamber representation, to examine how physiological parameter sensitivities vary with model structure. Time-varying elastance functions are used to represent cardiac dynamics, and global sensitivity analysis is performed using Sobol and Morris methods to quantify the impact of key physiological parameters, including venous return, myocardial contractility, total peripheral resistance, and arterial compliance. The results demonstrate that sensitivity rankings differ substantially between the two models, highlighting the role of model granularity and parameter interactions in shaping cardiovascular responses. These findings support sensitivity-driven model reduction and provide a foundation for scalable, non-invasive cardiovascular simulation frameworks.
Cardiovascular mortality is shaped by interacting demographic, environmental, and structural processes operating across multiple spatial scales. Conventional epidemiologic analyses often rely on aggregate summaries or single-model formulations that obscure hierarchical variation and contextual heterogeneity. We present a reproducible multilevel statistical inference framework integrating Normal (age-adjusted), Poisson (count-based), and population-offset Poisson models to quantify cardiovascular mortality across nested geographic units while separating demographic effects from structural variation. The framework was applied to county-level mortality data from Ohio and Pennsylvania (1999-2020) using MLwiN hierarchical models for seven cardiovascular disease (CVD) subtypes. Fixed effects included year, sex, race, PM2.5, and O3, while county-level random intercepts captured spatial heterogeneity. Complete model equations are provided in the Supplementary Material. The framework reveals complementary perspectives on cardiovascular risk unavailable from a single model. Age-adjusted mortality declined more rapidly in Pennsylvania than Ohio, whereas Poisson models identified post-2010 sta
Cardiovascular signals such as photoplethysmography (PPG), electrocardiography (ECG), and blood pressure (BP) are inherently correlated and complementary, together reflecting the health of cardiovascular system. However, their joint utilization in real-time monitoring is severely limited by diverse acquisition challenges from noisy wearable recordings to burdened invasive procedures. Here we propose UniCardio, a multi-modal diffusion transformer that reconstructs low-quality signals and synthesizes unrecorded signals in a unified generative framework. Its key innovations include a specialized model architecture to manage the signal modalities involved in generation tasks and a continual learning paradigm to incorporate varying modality combinations. By exploiting the complementary nature of cardiovascular signals, UniCardio clearly outperforms recent task-specific baselines in signal denoising, imputation, and translation. The generated signals match the performance of ground-truth signals in detecting abnormal health conditions and estimating vital signs, even in unseen domains, while ensuring interpretability for human experts. These advantages position UniCardio as a promising a
Smart rings offer a convenient way to continuously and unobtrusively monitor cardiovascular physiological signals. However, a gap remains between the ring hardware and reliable methods for estimating cardiovascular parameters, partly due to the lack of publicly available datasets and standardized analysis tools. In this work, we present $τ$-Ring, the first open-source ring-based dataset designed for cardiovascular physiological sensing. The dataset comprises photoplethysmography signals (infrared and red channels) and 3-axis accelerometer data collected from two rings (reflective and transmissive optical paths), with 28.21 hours of raw data from 34 subjects across seven activities. $τ$-Ring encompasses both stationary and motion scenarios, as well as stimulus-evoked abnormal physiological states, annotated with four ground-truth labels: heart rate, respiratory rate, oxygen saturation, and blood pressure. Using our proposed RingTool toolkit, we evaluated three widely-used physics-based methods and four cutting-edge deep learning approaches. Our results show superior performance compared to commercial rings, achieving best MAE values of 5.18 BPM for heart rate, 2.98 BPM for respirato
Low-dose chest computed tomography (LDCT) captures pulmonary and cardiac structures in a single scan, enabling joint assessment of lung and cardiovascular health. Existing approaches typically model these domains independently and do not explicitly represent their physiological interactions. We propose an Explainable Cross-Disease Reasoning Framework for cardiovascular risk assessment from LDCT. The framework follows a constrained clinical-information pathway: it extracts pulmonary findings, grounds cross-organ mechanisms in medical knowledge, and produces a cardiovascular prediction with a natural-language rationale. It combines four components: a frozen lung-risk prior, a pulmonary perception module, an agentic reasoning module, and a cardiac subvolume feature extractor. Their outputs are fused to integrate localized cardiac evidence with mechanism-level pulmonary context. On the National Lung Screening Trial cohort, the framework achieves an AUC of 0.919 for CVD screening and up to 0.838 for CVD mortality prediction, outperforming cardiac-specific, single-disease, and foundation-model baselines. Targeted controls indicate that the gains are not explained by additional thoracic v
Cardiovascular events, such as heart attacks and strokes, remain a leading cause of mortality globally, necessitating meticulous monitoring and adjudication in clinical trials. This process, traditionally performed manually by clinical experts, is time-consuming, resource-intensive, and prone to inter-reviewer variability, potentially introducing bias and hindering trial progress. This study addresses these critical limitations by presenting a novel framework for automating the adjudication of cardiovascular events in clinical trials using Large Language Models (LLMs). We developed a two-stage approach: first, employing an LLM-based pipeline for event information extraction from unstructured clinical data and second, using an LLM-based adjudication process guided by a Tree of Thoughts approach and clinical endpoint committee (CEC) guidelines. Using cardiovascular event-specific clinical trial data, the framework achieved an F1-score of 0.82 for event extraction and an accuracy of 0.68 for adjudication. Furthermore, we introduce the CLEART score, a novel, automated metric specifically designed for evaluating the quality of AI-generated clinical reasoning in adjudicating cardiovascul
Background: Photoplethysmography (PPG), increasingly available through wearable devices, provides a non-invasive means of monitoring human hemodynamics. In this study, we introduce artificial intelligence-derived photoplethysmography (AI-PPG) age, a deep learning-based estimate of biological age from raw PPG signals, and evaluate its potential as a digital biomarker for cardiovascular health. Methods: We developed a deep learning model with a distribution-aware loss function to reduce bias from imbalanced data. The model was trained and evaluated on the UK Biobank cohort (N = 212,231). We analyzed the association between the AI-PPG age gap (AI-PPG age minus calendar age) and multiple cardiovascular and metabolic outcomes, assessed its longitudinal value using serial PPG measurements, and externally validated its generalizability in an independent MIMIC-III-derived cohort (N = 2,343). Results: After adjusting for key confounders, participants with an AI-PPG age gap greater than 9 years have a significantly higher risk of major adverse cardiovascular and cerebrovascular events (hazard ratio of 2.37, p = 8.46x10$^{-80}$), as well as seven secondary outcomes including coronary heart di
Continuous cardiovascular monitoring is essential for managing circulatory health and disease, yet most wearable sensors are constrained by reliance on electrical transduction and built-in electronics. We present a circuit-free, wholly optical approach using diffraction from a skin-interfaced nanostructured surface to detect minute skin strains from the arterial pulse. A smartphone camera records the shifting diffraction pattern in real time, removing the need for spectrometers or other optical hardware. In phantom and human studies, we recovered high-fidelity arterial pulse waves and detected benign arrhythmic events in close agreement with a clinical reference. Derived waveforms captured features linked to arterial stiffness, a key cardiovascular risk marker. Our approach uses battery-free, cost-effective, and disposable platforms enabling scalable monitoring for healthcare and broad consumer applications.
Cardiovascular diseases (CVDs) are a main cause of mortality globally, accounting for 31% of all deaths. This study involves a cardiovascular disease (CVD) dataset comprising 68,119 records to explore the influence of numerical (age, height, weight, blood pressure, BMI) and categorical gender, cholesterol, glucose, smoking, alcohol, activity) factors on CVD occurrence. We have performed statistical analyses, including t-tests, Chi-square tests, and ANOVA, to identify strong associations between CVD and elderly people, hypertension, higher weight, and abnormal cholesterol levels, while physical activity (a protective factor). A logistic regression model highlights age, blood pressure, and cholesterol as primary risk factors, with unexpected negative associations for smoking and alcohol, suggesting potential data issues. Model performance comparisons reveal CatBoost as the top performer with an accuracy of 0.734 and an ECE of 0.0064 and excels in probabilistic prediction (Brier score = 0.1824). Data challenges, including outliers and skewed distributions, indicate a need for improved preprocessing to enhance predictive reliability.
Early detection of cancer and cardiovascular diseases is fundamental to improving patient outcomes and reducing healthcare expenditure. Current cancer screening programs are targeted towards specific cancers and are often inaccessible to large parts of the population, particularly in remote regions. This project aimed to develop digital blood twins: machine learning models that leverage routinely collected blood test data, demographics, comorbidities, and prescribed medications, for scalable and cost-effective disease screening. Digital blood twins were constructed using the UK Biobank dataset (n = 373,269). Using age, sex, comorbidities, medication profiles, and blood test z-scores, three iterations of XGBoost classifiers were trained for broad cancer, colorectal cancer, and cardiovascular disease prediction. Model interpretability was achieved through SHAP and dimensionality reduction analyses (UMAP, t-SNE). Broad-category cancer models achieved ROC-AUC = 0.607-0.706. Colorectal cancer prediction demonstrated excellent discrimination (ROC-AUC = 0.816-0.993), and cardiovascular models showed clinical utility, notably for hypertension (ROC-AUC = 0.813, F1 = 0.861). SHAP revealed co
Continuous cardiovascular monitoring can play a key role in precision health. However, some fundamental cardiac biomarkers of interest, including stroke volume and cardiac output, require invasive measurements, e.g., arterial pressure waveforms (APW). As a non-invasive alternative, photoplethysmography (PPG) measurements are routinely collected in hospital settings. Unfortunately, the prediction of key cardiac biomarkers from PPG instead of APW remains an open challenge, further complicated by the scarcity of annotated PPG measurements. As a solution, we propose a hybrid approach that uses hemodynamic simulations and unlabeled clinical data to estimate cardiovascular biomarkers directly from PPG signals. Our hybrid model combines a conditional variational autoencoder trained on paired PPG-APW data with a conditional density estimator of cardiac biomarkers trained on labeled simulated APW segments. As a key result, our experiments demonstrate that the proposed approach can detect fluctuations of cardiac output and stroke volume and outperform a supervised baseline in monitoring temporal changes in these biomarkers.
This study investigates long-term cardiovascular complications in COVID-19 patients using advanced clustering techniques. The objective was to analyse ECG parameters, demographic data, comorbidities, and hospitalization details to identify patterns in cardiovascular health outcomes. We applied K-means clustering and identified three distinct clusters: Cluster 0 with moderate heart rate variability and ICU admissions, Cluster 1 with lower heart rate variability and ICU admissions, and Cluster 2 with higher heart rate variability and ICU admissions, indicating higher risk profiles.
Recent advancements in artificial intelligence (AI) have revolutionized cardiovascular medicine, particularly through integration with computed tomography (CT), magnetic resonance imaging (MRI), electrocardiography (ECG) and ultrasound (US). Deep learning architectures, including convolutional neural networks and generative adversarial networks, enable automated analysis of medical imaging and physiological signals, surpassing human capabilities in diagnostic accuracy and workflow efficiency. However, critical challenges persist, including the inability to validate input data accuracy, which may propagate diagnostic errors. This review highlights AI's transformative potential in precision diagnostics while underscoring the need for robust validation protocols to ensure clinical reliability. Future directions emphasize hybrid models integrating multimodal data and adaptive algorithms to refine personalized cardiovascular care.
Cardiovascular diseases are the leading cause of mortality globally, necessitating advancements in diagnostic techniques. This study explores the application of wavelet transformation for classifying electrocardiogram (ECG) signals to identify various cardiovascular conditions. Utilizing the MIT-BIH Arrhythmia Database, we employed both continuous and discrete wavelet transforms to decompose ECG signals into frequency sub-bands, from which we extracted eight statistical features per band. These features were then used to train and test various classifiers, including K-Nearest Neighbors and Support Vector Machines, among others. The classifiers demonstrated high efficacy, with some achieving an accuracy of up to 96% on test data, suggesting that wavelet-based feature extraction significantly enhances the prediction of cardiovascular abnormalities in ECG data. The findings advocate for further exploration of wavelet transforms in medical diagnostics to improve automation and accuracy in disease detection. Future work will focus on optimizing feature selection and classifier parameters to refine predictive performance further.