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Increased LV wall thickness is frequently encountered in transthoracicechocardiography (TTE). While accurate and early diagnosis is clinically important,
given the differences in available therapeutic options and prognosis, an extensive workup
is often required for establishing the diagnosis. I propose the first echo-based, automated
deep learning model with a fusion architecture to facilitate the…
Increased LV wall thickness is frequently encountered in transthoracicechocardiography (TTE). While accurate and early diagnosis is clinically important,
given the differences in available therapeutic options and prognosis, an extensive workup
is often required for establishing the diagnosis. I propose the first echo-based, automated
deep learning model with a fusion architecture to facilitate the evaluation and diagnosis
of increased left ventricular (LV) wall thickness. Patients with an established diagnosis
for increased LV wall thickness (hypertrophic cardiomyopathy (HCM), cardiac
amyloidosis (CA), and hypertensive heart disease (HTN)/others) between 1/2015 to
11/2019 at Mayo Clinic Arizona were identified. The cohort was divided into
80%/10%/10% for training, validation, and testing sets, respectively. Six baseline TTE
views were used to optimize a pre-trained InceptionResnetV2 model, each model output
was used to train a meta-learner under a fusion architecture. Model performance was
assessed by multiclass area under the receiver operating characteristic curve (AUROC).
A total of 586 patients were used for the final analysis (194 HCM, 201 CA, and 191
HTN/others). The mean age was 55.0 years, and 57.8% were male. Among the individual
view-dependent models, the apical 4 chamber model had the best performance (AUROC:
HCM: 0.94, CA: 0.73, and HTN/other: 0.87). The final fusion model outperformed all the
view-dependent models (AUROC: CA: 0.90, HCM: 0.93, and HTN/other: 0.92). I
successfully established an automatic end-to-end deep learning model framework that
accurately differentiates the major etiologies of increased LV wall thickness, including
HCM and CA from the background of HTN/other diagnoses.
