Cited by 66ECG Monitoring and AnalysisArtificial Intelligence in HealthcareHeart Failure Treatment and Management

Artificial Intelligence–Enabled Prediction of Heart Failure Risk From Single-Lead Electrocardiograms

Open access
Dhingra, Lovedeep S., Aminorroaya, Arya, Pedroso, Aline F., Khunte, Akshay, Sangha, Veer, McIntyre, Daniel, Chow, Clara K., Asselbergs, Folkert W. +6 more·2025·JAMA Cardiology

Published version of a preprint

Abstract

Importance Despite the availability of disease-modifying therapies, scalable strategies for heart failure (HF) risk stratification remain elusive. Portable devices capable of recording single-lead electrocardiograms (ECGs) may enable large-scale community-based risk assessment. Objective To evaluate whether an artificial intelligence (AI) algorithm can predict HF risk from noisy single-lead ECGs. Design, setting, and participants A retrospective cohort study of individuals without HF at baseline was conducted among individuals with conventionally obtained outpatient ECGs in the integrated Yale New Haven Health System (YNHHS) and prospective population-based cohorts of the UK Biobank (UKB) and the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Data analysis was performed from September 2023 to February 2025. Exposure AI-ECG-defined risk of left ventricular systolic dysfunction (LVSD). Main outcomes and measures Among individuals with ECGs, lead I ECGs were isolated and a noise-adapted AI-ECG model (to simulate ECG signals from wearable devices) trained to identify LVSD was deployed. The association of the model probability with new-onset HF, defined as the first HF hospitalization, was evaluated. The discrimination of AI-ECG was compared against 2 risk scores for new-onset HF (Pooled Cohort Equations to Prevent Heart Failure [PCP-HF] and Predicting Risk of Cardiovascular Disease Events [PREVENT] equations) using the Harrel C statistic, integrated discrimination im…

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Registry

Crossref · 10.1001/jamacardio.2025.0492

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  • Recent studies utilising UK Biobank data have demonstrated that AI-powered electrocardiogram analysis can predict heart failure risk from single-lead recordings, showing potential for scalable community-based risk assessment using portable devices.

    “Recent studies utilising UK Biobank data have demonstrated how AI-powered electrocardiogram analysis can predict heart failure risk from single-lead recordings, showcasing the potential for scalable community-based risk assessment using portable devices (65).”
  • Previously, applications of artificial intelligence for electrocardiograms have shown potential to detect signatures of structural heart diseases.

    “Previously applications of artificial intelligence for electrocardiograms (AI-ECG) have shown potential to detect signatures of SHDs.10-18”

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Authors
Dhingra, L. S., Aminorroaya, A., Pedroso, A. F., Khunte, A., Sangha, V., McIntyre, D., Chow, C. K., Asselbergs, F. W., Brant, L. C. C., Barreto, S. M., Ribeiro, A. L. P., Krumholz, H. M., Oikonomou, E. K., & Khera, R.
Affiliations
  • Yale University (US)
  • The University of Sydney (AU)
  • National Institute for Health and Care Research (GB)
  • Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  • Universidade Federal de Minas Gerais (BR)
  • Yale New Haven Hospital (US)
Corresponding author
Khera, Rohan
Venue
JAMA Cardiology
Published
2025-06-01
Volume
10
Issue
6
Pages
574
ISSN
2380-6583 (ISSN-L)
OpenAlex
W4409502323
Cited by
65
References
83
Citations by year
2026: 45 · 2025: 20
FWCI
45.41
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • JAMA Cardiology (publishedVersion)
  • medRxiv (acceptedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • PubMed Central (submittedVersion, cc-by-nc)
  • UCL Discovery (University College London) (submittedVersion)
  • PubMed Central (submittedVersion)
Funders
  • National Institutes of Health (1r01ag089981-01)
  • National Heart, Lung, and Blood Institute (F32HL170592, R01HL167858, K23HL153775)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
  • Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords
heart failure prediction, single-lead ECG, artificial intelligence, wearable devices, left ventricular systolic dysfunction, new-onset heart failure, risk stratification, community-based risk assessment, UK Biobank, ELSA-Brasil

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