Journal of Korean medical science
Screening for Left Ventricular Dysfunction in Sepsis Using a Smartphone ECG Analysis Application: A Multicenter Validation Study
By Park YS, Kim J, Jo YH and 5 others.
Abstract
Background
Sepsis-induced left ventricular (LV) dysfunction complicates fluid resuscitation, increasing the risk of pulmonary edema and worsening outcomes. Echocardiographic assessment is often delayed, and natriuretic peptides such as N-terminal pro-B-type natriuretic peptide (NT-proBNP) have limited diagnostic accuracy in this setting. We evaluated a smartphone-based electrocardiogram (ECG) analysis application for screening LV dysfunction in patients with sepsis.
Methods
In this multicenter retrospective observational study, we included 425 adult sepsis patients from three university hospitals who underwent both a 12-lead ECG and transthoracic echocardiography within 72 hours of emergency department admission. ECG images displayed on a monitor were photographed and analyzed using an artificial intelligence (AI)-based smartphone application (ECG Buddy™), which generated a quantitative digital biomarker for LV dysfunction (quantitative electrocardiogram scores for LV dysfunction [QCG-LVDys]). LV dysfunction was defined as a left ventricular ejection fraction ≤ 40%. The diagnostic performance of QCG-LVDys for detecting LV dysfunction was evaluated using area under the receiver operating characteristic curve (ROC-AUC). A predefined comparison with NT-proBNP was performed in the single center where NT-proBNP was routinely measured.