基于外周动脉血流动力学信息的中心动脉血压预测:一种深度学习模型
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上海交通大学

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国家自然科学基金项目(面上项目,重点项目,重大项目)


Central aortic pressure prediction based on peripheral arterial hemodynamic information: A deep learning model
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Shanghai Jiao Tong University

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    摘要:

    目的:中心动脉血压(central aortic blood pressure, CAP)是心血管事件的重要关联因子之一。利用特定算法将外周动脉血压转换为CAP的方法存在估测精度个体差异大、稳定性差等问题。本研究旨在探讨利用深度学习(deep learning, DL)模型融合外周血流动力学信息来预测CAP的可行性。方法:为了解决常规临床检测难以获得DL模型开发和验证所需的大批量高质量数据这一问题,本研究采用人体心血管系统的计算机模型生成虚拟人样本,具体包括用于模型开发的2000例样本以及用于模型验证的100例样本。另外,还生成了心血管特性与开发集样本不同的100例样本用于模型泛化能力测试,定义为分布外样本。DL模型采用具有多头注意力机制的卷积神经网络架构,以四处外周动脉的血流速度波形(含随机误差,以模拟超声多普勒测量结果)及肱动脉收缩压、舒张压作为输入信息,以CAP作为输出信息。结果:DL模型在开发集中收敛性良好,损失函数值可降至5×10-3以下。对分布内验证样本的测试显示,CAP波形的预测误差小于1.5mmHg(R2>0.98),收缩压和舒张压的平均预测误差小于1.3mmHg;而对分布外样本的测试发现,CAP的预测误差显著增大,收缩压的平均预测误差达到5.7mmHg以上。结论:DL模型能够基于外周血流动力学信息快速预测CAP,但其预测精度受模型训练样本对个体差异的覆盖能力制约。未来研究可通过采集涵盖广泛个体差异的大规模临床数据,进一步提升DL模型的临床应用价值。

    Abstract:

    Objective: Central aortic blood pressure (CAP) is a critical factor associated with cardiovascular events. Current methods for converting peripheral blood pressure to CAP using specific algorithms suffer from significant inter-individual variability in estimation accuracy and poor stability. This study aims to investigate the feasibility of using a deep learning (DL) model to predict CAP by fusing non-invasively measurable peripheral hemodynamic information. Methods: To address the challenge of acquiring large-scale and high-quality clinical data required for DL model development, we used a computational model of the human cardiovascular system to generate virtual human samples, including 2000 samples for model development and 100 in-distribution samples for validation. Additionally, 100 samples with distinct cardiovascular properties were generated for generalization testing, defined as out-of-distribution dataset. The DL model employed a CNN framework with a multi-head attention mechanism, taking blood flow velocity waveforms from four peripheral arteries (with artificially introduced random measurement errors) and brachial systolic/diastolic pressures as inputs, and CAP as the output. Results: The DL model showed good convergence in training (loss function<5×10-3). Testing on the in-distribution validation dataset showed a CAP waveform prediction error of less than 1.5mmHg (R2>0.98), with the mean prediction errors for systolic and diastolic pressure below 1.3mmHg. However, testing on the out-of-distribution dataset revealed a significant increase in CAP prediction error, with the mean systolic pressure error exceeding 5.7mmHg. Conclusion: The DL model can rapidly predict CAP based on peripheral hemodynamic information, but its prediction accuracy is constrained by the coverage capability of the training samples regarding individual differences. Future research should focus on collecting large-scale clinical data covering a wide range of individual variations to further enhance the clinical value of DL models.

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  • 收稿日期:2025-11-07
  • 最后修改日期:2025-11-25
  • 录用日期:2025-11-28
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