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Cardiac age detected by machine learning applied to the surface ECG of healthy subjects: Creation of a benchmark
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  • Hein E.C. van der Wall,
  • Gerardus J. Hassing,
  • Robert-Jan Doll,
  • Gerard J.P. van Westen,
  • Adam Cohen,
  • Jasper Selder,
  • Michiel Kemme,
  • Jacobus Burggraaf,
  • Pim Gal
Hein E.C. van der Wall
Centre for Human Drug Research

Corresponding Author:hvdwall@chdr.nl

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Gerardus J. Hassing
Centre for Human Drug Research
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Robert-Jan Doll
Centre for Human Drug Research
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Gerard J.P. van Westen
Leiden Academic Centre for Drug Research
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Adam Cohen
Centre for Human Drug Research
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Jasper Selder
Amsterdam UMC Locatie VUmc
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Michiel Kemme
Amsterdam UMC - Locatie VUMC
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Jacobus Burggraaf
Centre for Human Drug Research
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Pim Gal
Centre for Human Drug Research
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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.