Background: Although aortic stenosis (AS) is the most common valvular heart disease in the western world, many affected patients remain undiagnosed. Auscultation is a readily available screening tool for AS. However, it requires a high level of professional expertise.
Hypothesis: An AI algorithm can detect AS using audio files with the same accuracy as experienced cardiologists.
Methods: A deep neural network (DNN) was trained by preprocessed audio files of 100 patients with AS and 100 controls. The DNN's performance was evaluated with a test data set of 40 patients. The primary outcome measures were sensitivity, specificity, and F1-score. Results of the DNN were compared with the performance of cardiologists, residents, and medical students.
Results: Eighteen percent of patients without AS and 22% of patients with AS showed an additional moderate or severe mitral regurgitation. The DNN showed a sensitivity of 0.90 (0.81-0.99), a specificity of 1, and an F1-score of 0.95 (0.89-1.0) for the detection of AS. In comparison, we calculated an F1-score of 0.94 (0.86-1.0) for cardiologists, 0.88 (0.78-0.98) for residents, and 0.88 (0.78-0.98) for students.
Conclusions: The present study shows that deep learning-guided auscultation predicts significant AS with similar accuracy as cardiologists. The results of this pilot study suggest that AI-assisted auscultation may help general practitioners without special cardiology training in daily practice.
Keywords: aortic stenosis; artificial intelligence; auscultation; deep neural network; machine learning; valvular heart disease.
© 2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.