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Review article |

Artificial neural networks: Current status in cardiovascular medicine FREE

Dipti Itchhaporia, MD; Peter B. Snow, PhD; Robert J. Almassy, MS; William J. Oetgen, MD, MBA, FACC
[+] Author Information

This study was supported in part by Georgetown University, Washington, D. C. and by Kaman Sciences Corporation, Colorado Springs and Alexandria.Address for correspondence: Dr. Dipti Itchhaporia, Division of Cardiology, Stanford Medical Center, 300 Pasteur Drive, H2321, Stanford, California 94305.

American College of Cardiology

J Am Coll Cardiol. 1996;28(2):515-521. doi:10.1016/0735-1097(96)00174-X
Published online

  Artificial neural networks are a form of artificial computer intelligence that have been the subject of renewed research interest in the last 10 years. Although they have been used extensively for problems in engineering, they have only recently been applied to medical problems, particularly in the fields of radiology, urology, laboratory medicine and cardiology. An artificial neural network is a distributed network of computing elements that is modeled after a biologic neural system and may be implemented as a computer software program. It is capable of identifying relations in input data that are not easily apparent with current common analytic techniques. The functioning artificial neural network's knowledge is built on learning and experience from previous input data. On the basis of this prior knowledge, the artificial neural network can predict relations found in newly presented data sets. In cardiology, artificial neural networks have been successfully applied to problems in the diagnosis and treatment of coronary artery disease and myocardial infarction, in electrocardiographic interpretation and detection of arrhythmias and in image analysis in cardiac radiography and sonography. This report focuses on the current status of artificial neural network technology in cardiovascular medical research.

References

Miller  AS, Blott  BH, Hames  TK; Review of neural network applications in medical imaging and signal processing. Med Biol Eng Comput. 30 1992:44964
Guerriere  MR, Detsky  AS; Neural networks: what are they?. Ann Intern Med. 115 1991:906-907.
PubMed
Shufflebarger  CM; What is a neural network?. Ann Emerg Med. 21 1992:1461-1462.
CrossRef | PubMed
Rumelhart  DE, Hinton  GE, Williams  RJ; Learning internal representations by error propagation.Rumelhart  DE, McClelland  JL;Parallel Distributed Processing Vol 1 1986 MIT Press New York:318-364.
Scott  JA, Palmer  EL; Neural network analysis of ventilation-perfusion lung scans. Radiology. 186 1993:661-664.
PubMed
Ebell  MH; Artificial neural networks for predicting failure to survive following in-hospital cardiopulmonary resuscitation. J Fam Pract. 36 1993:297-303.
PubMed
Poli  R, Cagnoni  S, Livi  R, Coppini  G, Valli  G; A neural network expert system for diagnosing and treating hypertension. Computer. (3) 1991:64-71.
Akay  M; Noninvasive diagnosis of coronary artery disease using a neural network algorithm. Biol Cybern. 67 1992:361-367.
CrossRef | PubMed
[abstract]ltchhaporia  D, Almassy  R, Kaufman  L, Snow  P, Oetgen  W; Artificial neural networks can predict significant coronary disease. J Am Coll Cardiol. 25 1995:328A
CrossRef
Gindi  GR, Darken  CJ, O'Brien  KM, Stetz  ML, Deckelbaum  LI; Neural network and conventional classifiers for fluorescence-guided laser angioplasty. IEEE Trans Biomed Eng. 38 1991:246-252.
CrossRef | PubMed
Baxt  WG; Use of an artificial neural network for data analysis in clinical decision-making: the diagnosis of acute coronary occlusion. Neural Comput. 2 1990:480-489.
CrossRef
Baxt  WG; Use of an artificial neural network for the diagnosis of myocardial infarction. Ann Intern Med. 115 1991:843-848.
PubMed
Baxt  WG; Analysis of the clinical variables driving decision in an artificial neural network trained to identify the presence of myocardial infarction. Ann Emerg Med. 21 1992:1439-1444.
CrossRef | PubMed
Furlong  JW, Dupuy  ME, Heinsimer  JA; Neural network analysis of serial cardiac enzyme data: a clinical application of artificial machine intelligence. Am J Clin Pathol. 96 1991:134-141.
PubMed
Macfarlane  PW, Devine  B, Latif  S; Methodology of ECG interpretation in the Glasgow program. Methods Inf Med. 29 1990:354
PubMed
Macfarlane  PW; A brief history of computer assisted electrocardiography. Methods Inf Med. 29 1990:272-281.
PubMed
Bortolan  G, Degani  R, Willems  JL; Design of neural networks for classification of electrocardiographic signals.Proc 12th Ann Int Conf IEEE Eng Med Biol Soc 3 1990:1467-1468.
Edenbrandt  L, Devine  B, Macfarlane  PW; Classification of electrocardiographic ST-T segments—human expert vs artificial neural network. Eur Heart J. 14 1993:464-468.
CrossRef | PubMed
Suzuki  Y, Ono  K; Personal computer system for ECG ST-segment recognition based on neural networks. Med Biol Eng Comput. 30 1992:2-8.
CrossRef | PubMed
Heden  B, Edenbrandt  L, Haisty  WK, Pahlm  O; Artificial neural networks for the electrocardiographic diagnosis of healed myocardial infarction. Am J Cardiol. 74 1994:5-8.
CrossRef | PubMed
SupplYang  TF, Devine  B, Macfarlane  PW; Use of artificial neural networks within deterministic logic for the computer ECG diagnosis of inferior myocardial infarction. J Electrocardiol. 27 1994:188-193.
CrossRef | PubMed
SupplYang  TF, Devine  B, Macfarlane  PW; Deterministic logic versus softwarebased artificial neural networks in the diagnosis of atrial fibrillation. J Electrocardiol. 26 1993:90-94.
PubMed
Yang  TF, Devine  B, Macfarlane  PW; Artificial neural networks for the diagnosis of atrial fibrillation. Med Biol Eng Comput. 32 1994:615-619.
CrossRef | PubMed
Dassen  WR, Karthaus  VL, Talmon  JL, Mulleneers  RG, Smeets  JL, Wellens  HJ; Evaluation of new self-learning techniques for the generation of criteria for differentiation of wide-QRS tachycardia in supraventricular tachycardia and ventricular tachycardia. Clin Cardiol. 18 1995:103-108.
CrossRef | PubMed
Lee  SC; Using translation invariant neural network to diagnose heart arrhythmia. Proc 11th Ann Int Conf IEEE Eng in Med Biol Sci. 1989:2025-2026.
Farrugia  S, Yee  H, Nickolls  P; Implantable cardioverter defibrillator electrogram recognition with a multilayer perceptron. PACE. 16 1993:228-234.
CrossRef | PubMed
Iwata  A, Nagasaka  Y, Suzumura  N; Data compression of the ECG using neural network for digital Holter monitor. IEEE Eng Med Biol Mag. 9 1990:53-59.
CrossRef | PubMed
[abstract]Morytko  JA, Tracy  CM, Snow  PB, Solomon  AJ; Localization of accessory pathways using artificial neural network analysis of the surface electrocardiogram. Circulation. 90 (Suppl I) 1994:I-436.
Dassen  WR, Mulleneers  RG, Den Dulk  K; An artificial neural network to localize atrioventricular accessory pathways in patients suffering from the Wolff-Parkinson-White syndrome. PACE. 13 1990:1792-1796.
CrossRef | PubMed
Rosen  SE, Bauch  L, Fisher  EA, Vorchheimer  D, Budd  JH, Goldman  ME; Current status of echocardiographic automated border detection. Cardio. 12 1993:44-54.
Cios  KJ, Chen  K, Langenderfer  RA; Use of neural networks in detecting cardiac diseases from echocardiographic images. IEEE Med Biol. 1990; Sept:58-60.
Fujita  H, Katafuchi  T, Uehara  T, Nishimura  T; Application of artificial neural network to computer-aided diagnosis of coronary artery disease in myocardial SPECT bull's-eye images. J Nucl Med. 33 1992:272-276.
PubMed
Narayanan  MN, Lucas  SB; A genetic algorithm to improve a neural network to predict a patient's response to warfarin. Methods Inf Med. 32 1993:55-58.
PubMed
Lette  J, Colletti  BW, Cerino  M; Artificial intelligence versus logistic regression modelling to predict cardiac complications after noncardiac surgery. Clin Cardiol. 17 1994:609-614.
CrossRef | PubMed
Tu  JV, Guerriere  MR; Use of a neural network as a predictive instrument for length of stay in the intensive care unit following cardiac surgery. Comput Biomed Res. 26 1993:220-229.
CrossRef | PubMed
Foo  TT, Hull  SS, Cheung  JY; A PC based neural network algorithm for measurement of heart rate variability. Biomed Sci Instrum. 31 1995:35-40.
PubMed
Cathers  I; Neural network assisted cardiac auscultation. Artif Intell Med. 7 1995:53-66.
CrossRef | PubMed
Georgiadis  D, Kaps  M, Siebler  M; Variability of Doppler microembolic signal counts in patients with prosthetic cardiac valves. Stroke. 26 1995:439-443.
CrossRef | PubMed
Doig  GS; Prognostication, procrastination and artificial neural networks. ACC Curr J Rev. 3 1994:60-62.

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References

Miller  AS, Blott  BH, Hames  TK; Review of neural network applications in medical imaging and signal processing. Med Biol Eng Comput. 30 1992:44964
Guerriere  MR, Detsky  AS; Neural networks: what are they?. Ann Intern Med. 115 1991:906-907.
PubMed
Shufflebarger  CM; What is a neural network?. Ann Emerg Med. 21 1992:1461-1462.
CrossRef | PubMed
Rumelhart  DE, Hinton  GE, Williams  RJ; Learning internal representations by error propagation.Rumelhart  DE, McClelland  JL;Parallel Distributed Processing Vol 1 1986 MIT Press New York:318-364.
Scott  JA, Palmer  EL; Neural network analysis of ventilation-perfusion lung scans. Radiology. 186 1993:661-664.
PubMed
Ebell  MH; Artificial neural networks for predicting failure to survive following in-hospital cardiopulmonary resuscitation. J Fam Pract. 36 1993:297-303.
PubMed
Poli  R, Cagnoni  S, Livi  R, Coppini  G, Valli  G; A neural network expert system for diagnosing and treating hypertension. Computer. (3) 1991:64-71.
Akay  M; Noninvasive diagnosis of coronary artery disease using a neural network algorithm. Biol Cybern. 67 1992:361-367.
CrossRef | PubMed
[abstract]ltchhaporia  D, Almassy  R, Kaufman  L, Snow  P, Oetgen  W; Artificial neural networks can predict significant coronary disease. J Am Coll Cardiol. 25 1995:328A
CrossRef
Gindi  GR, Darken  CJ, O'Brien  KM, Stetz  ML, Deckelbaum  LI; Neural network and conventional classifiers for fluorescence-guided laser angioplasty. IEEE Trans Biomed Eng. 38 1991:246-252.
CrossRef | PubMed
Baxt  WG; Use of an artificial neural network for data analysis in clinical decision-making: the diagnosis of acute coronary occlusion. Neural Comput. 2 1990:480-489.
CrossRef
Baxt  WG; Use of an artificial neural network for the diagnosis of myocardial infarction. Ann Intern Med. 115 1991:843-848.
PubMed
Baxt  WG; Analysis of the clinical variables driving decision in an artificial neural network trained to identify the presence of myocardial infarction. Ann Emerg Med. 21 1992:1439-1444.
CrossRef | PubMed
Furlong  JW, Dupuy  ME, Heinsimer  JA; Neural network analysis of serial cardiac enzyme data: a clinical application of artificial machine intelligence. Am J Clin Pathol. 96 1991:134-141.
PubMed
Macfarlane  PW, Devine  B, Latif  S; Methodology of ECG interpretation in the Glasgow program. Methods Inf Med. 29 1990:354
PubMed
Macfarlane  PW; A brief history of computer assisted electrocardiography. Methods Inf Med. 29 1990:272-281.
PubMed
Bortolan  G, Degani  R, Willems  JL; Design of neural networks for classification of electrocardiographic signals.Proc 12th Ann Int Conf IEEE Eng Med Biol Soc 3 1990:1467-1468.
Edenbrandt  L, Devine  B, Macfarlane  PW; Classification of electrocardiographic ST-T segments—human expert vs artificial neural network. Eur Heart J. 14 1993:464-468.
CrossRef | PubMed
Suzuki  Y, Ono  K; Personal computer system for ECG ST-segment recognition based on neural networks. Med Biol Eng Comput. 30 1992:2-8.
CrossRef | PubMed
Heden  B, Edenbrandt  L, Haisty  WK, Pahlm  O; Artificial neural networks for the electrocardiographic diagnosis of healed myocardial infarction. Am J Cardiol. 74 1994:5-8.
CrossRef | PubMed
SupplYang  TF, Devine  B, Macfarlane  PW; Use of artificial neural networks within deterministic logic for the computer ECG diagnosis of inferior myocardial infarction. J Electrocardiol. 27 1994:188-193.
CrossRef | PubMed
SupplYang  TF, Devine  B, Macfarlane  PW; Deterministic logic versus softwarebased artificial neural networks in the diagnosis of atrial fibrillation. J Electrocardiol. 26 1993:90-94.
PubMed
Yang  TF, Devine  B, Macfarlane  PW; Artificial neural networks for the diagnosis of atrial fibrillation. Med Biol Eng Comput. 32 1994:615-619.
CrossRef | PubMed
Dassen  WR, Karthaus  VL, Talmon  JL, Mulleneers  RG, Smeets  JL, Wellens  HJ; Evaluation of new self-learning techniques for the generation of criteria for differentiation of wide-QRS tachycardia in supraventricular tachycardia and ventricular tachycardia. Clin Cardiol. 18 1995:103-108.
CrossRef | PubMed
Lee  SC; Using translation invariant neural network to diagnose heart arrhythmia. Proc 11th Ann Int Conf IEEE Eng in Med Biol Sci. 1989:2025-2026.
Farrugia  S, Yee  H, Nickolls  P; Implantable cardioverter defibrillator electrogram recognition with a multilayer perceptron. PACE. 16 1993:228-234.
CrossRef | PubMed
Iwata  A, Nagasaka  Y, Suzumura  N; Data compression of the ECG using neural network for digital Holter monitor. IEEE Eng Med Biol Mag. 9 1990:53-59.
CrossRef | PubMed
[abstract]Morytko  JA, Tracy  CM, Snow  PB, Solomon  AJ; Localization of accessory pathways using artificial neural network analysis of the surface electrocardiogram. Circulation. 90 (Suppl I) 1994:I-436.
Dassen  WR, Mulleneers  RG, Den Dulk  K; An artificial neural network to localize atrioventricular accessory pathways in patients suffering from the Wolff-Parkinson-White syndrome. PACE. 13 1990:1792-1796.
CrossRef | PubMed
Rosen  SE, Bauch  L, Fisher  EA, Vorchheimer  D, Budd  JH, Goldman  ME; Current status of echocardiographic automated border detection. Cardio. 12 1993:44-54.
Cios  KJ, Chen  K, Langenderfer  RA; Use of neural networks in detecting cardiac diseases from echocardiographic images. IEEE Med Biol. 1990; Sept:58-60.
Fujita  H, Katafuchi  T, Uehara  T, Nishimura  T; Application of artificial neural network to computer-aided diagnosis of coronary artery disease in myocardial SPECT bull's-eye images. J Nucl Med. 33 1992:272-276.
PubMed
Narayanan  MN, Lucas  SB; A genetic algorithm to improve a neural network to predict a patient's response to warfarin. Methods Inf Med. 32 1993:55-58.
PubMed
Lette  J, Colletti  BW, Cerino  M; Artificial intelligence versus logistic regression modelling to predict cardiac complications after noncardiac surgery. Clin Cardiol. 17 1994:609-614.
CrossRef | PubMed
Tu  JV, Guerriere  MR; Use of a neural network as a predictive instrument for length of stay in the intensive care unit following cardiac surgery. Comput Biomed Res. 26 1993:220-229.
CrossRef | PubMed
Foo  TT, Hull  SS, Cheung  JY; A PC based neural network algorithm for measurement of heart rate variability. Biomed Sci Instrum. 31 1995:35-40.
PubMed
Cathers  I; Neural network assisted cardiac auscultation. Artif Intell Med. 7 1995:53-66.
CrossRef | PubMed
Georgiadis  D, Kaps  M, Siebler  M; Variability of Doppler microembolic signal counts in patients with prosthetic cardiac valves. Stroke. 26 1995:439-443.
CrossRef | PubMed
Doig  GS; Prognostication, procrastination and artificial neural networks. ACC Curr J Rev. 3 1994:60-62.

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