Research
AI calculates heart’s biological age through ECG data, predicts increased risk of mortality
Researchers have demonstrated that by using AI to analyse standard 12-lead electrocardiograph (ECG) data taken from almost half a million people, they were able to create an algorithm to predict the biological age of the heart. This algorithm could be used to identify those most at risk of cardiovascular events and mortality.
While everybody’s heart has an absolute chronological age – which is as old as that person is – hearts also have a theoretical ‘biological’ age that is based on how the heart functions. So, someone who is 50 but has poor heart health could have a biological heart age of 60, while someone of 50 with optimal heart health could have a biological heart age of 40.
“Our research showed that when the biological age of the heart exceeded its chronological age by seven years, the risk of all-cause mortality and major adverse cardiovascular events increased sharply,” said associate professor Yong-Soo Baek, Inha University Hospital, in South Korea.
“Conversely, if the algorithm estimated the biological heart as seven years younger than the chronological age, that reduced the risk of death and major adverse cardiovascular events.”
The integration of AI into clinical diagnostics presents novel opportunities for enhancing predictive accuracy in cardiology.
“Using AI to develop algorithms in this way introduces a potential paradigm shift in cardiovascular risk assessment,” said Baek.
Their study evaluated the prognostic capabilities of a deep learning based algorithm that calculates biological ECG heart age (AI ECG-heart age) from 12-lead ECGs, comparing its predictive power against traditional chronological age (CA) for mortality and cardiovascular outcomes.
A deep neural network was developed and trained on a substantial dataset of 425,051 12-lead ECGs collected over fifteen years, with subsequent validation and testing on an independent cohort of 97,058 ECGs. Comparative analyses were conducted among age and sex-matched patients differentiated by ejection fraction (EF).
In statistical models, an AI ECG-heart age exceeding the heart’s chronical age by seven years was associated with an increased the risk of all-cause mortality by 62 per cent and of MACE by 92 per cent. In contrast, an AI ECG heart age that was seven years younger than its chronological age reduced the risk of all-cause mortality by 14 per cent and MACE by 27 per cent.
Additionally, subjects with reduced ejection fraction consistently exhibited increased AI ECG heart ages along with prolonged QRS durations (the time taken for the heart’s electrical signal to travel through the ventricles, causing contraction) and corrected QT intervals (the total time needed for the heart’s electrical system to complete one cycle of contraction and relaxation).
The authors explain that the significance of the observed correlation between reduced ejection fraction and increased AI ECG heart ages, alongside prolonged QRS durations and corrected QT intervals, suggests that AI ECG heart age effectively reflects various cardiac depolarisation and repolarisation processes.
These indicators of electrical remodelling within the heart may signify underlying cardiac health conditions and their association with ejection fraction (EF).
However, Baek said: “It is crucial to obtain a statistically sufficient sample size in future studies to substantiate these findings further. This approach will enhance the robustness and applicability of AI ECG in clinical assessments of cardiac function and health.
“Biological heart age estimated by artificial intelligence from 12-lead electrocardiograms is strongly associated with increased mortality and cardiovascular events, underscoring its utility in enhancing early detection and preventive strategies in cardiovascular healthcare. This study confirms the transformative potential of AI in refining clinical assessments and improving patient outcomes.”
The longer someone has type 2 diabetes, the higher their cardiovascular disease risk, and changes in red blood cells may help explain it, new research suggests.
The study found red blood cells from patients with long-term diabetes harmed blood vessel function, while no such effect was seen in those newly diagnosed.
After seven years of follow-up, the blood cells of people initially diagnosed had developed the same harmful properties.
Zhichao Zhou, associate professor at Karolinska Institutet and lead author, said: “What really stands out in our study is that it is not only the presence of type 2 diabetes that matters, but how long you have had the disease.
“It is only after several years that red blood cells develop a harmful effect on blood vessels.”
Researchers at Karolinska Institutet in Sweden studied animals and patients with type 2 diabetes.
They identified microRNA-210, a small RNA that helps regulate gene activity, as a possible early biomarker of cardiovascular risk.
When its levels were restored in red blood cells, blood vessel function improved.
Eftychia Kontidou, doctoral student and first author, said: “If we can identify which patients are at greatest risk before vascular damage has already occurred, we can also become better at preventing complications.”
The researchers are now investigating whether the biomarker can be used in larger population studies.
Routine vaccines for adults may reduce dementia risk, a review of more than 100 million people suggests.
The research found both flu and shingles vaccines were associated with a lower risk in adults aged 50 and over.
The shingles (herpes zoster) jab was linked to a 24 per cent lower risk of any dementia and a 47 per cent lower risk of Alzheimer’s disease.
A joint Italian-Canadian neuroscience review points to a pattern that public health experts say is hard to ignore, suggesting vaccines against common infections may offer long-term protection against the UK’s leading cause of death.
With an ageing population, about two million people are projected to be living with dementia in the UK by 2050.
Prof Sir Andrew Pollard is director of the Oxford Vaccine Group and former chair of the Joint Committee on Vaccination and Immunisation.
He said: “Vaccines for pneumonia, shingles, and influenza in older adults have been shown to reduce the risk of serious infections and hospitalisation caused by these diseases.
“But studies in the past few years have raised the intriguing possibility that vaccination could also provide a welcome reduction in the risk of dementia, a disease which places a huge burden on society and the NHS.”
A separate large-scale randomised trial in Wales compared shingles vaccines Zostavax and Shingrix to address the “healthy user effect”, where people who get vaccinated tend to be more health-conscious. As both groups were vaccinated, this helped control for that bias.
The results showed those receiving the newer Shingrix vaccine had a substantially lower risk of developing dementia over subsequent years.
Dr Maxime Taquet, clinical lecturer in psychiatry at Oxford, who led that study, said: “The size and nature of this study makes these findings convincing, and should motivate further research.”
Weaker, fragmented body clocks are linked to higher dementia risk, new research suggests.
The study also found that people whose activity levels peaked later in the day, rather than earlier, faced a higher risk.
Circadian rhythm is the body’s internal clock, regulating the 24-hour sleep-wake cycle and other processes including hormones, digestion and body temperature.
With a strong rhythm, the body clock aligns well with the 24-hour day, sending clear signals for body functions.
Researchers at UT Southwestern Medical Center in Texas studied 2,183 people with an average age of 79 who did not have dementia.
Participants wore small heart monitors for an average of 12 days to measure rest and activity patterns.
Over an average follow-up of three years, 176 people developed dementia. Those with weaker rhythms had nearly 2.5 times the risk of dementia compared to those with the strongest rhythms.
People whose activity peaked at 2.15pm or later had a 45 per cent increased risk compared to those peaking earlier in the afternoon.
Wendy Wang, the study author, said: “Changes in circadian rhythms happen with ageing, and evidence suggests that circadian rhythm disturbances may be a risk factor for neurodegenerative diseases like dementia.
“Disruptions in circadian rhythms may alter body processes like inflammation, and may interfere with sleep, possibly increasing amyloid plaques linked to dementia, or reducing amyloid clearance from the brain.
“Future studies should examine the potential role of circadian rhythm interventions, such as light therapy or lifestyle changes, to determine if they may help lower a person’s risk of dementia.”
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