Early Detection of Coronary Microvascular Dysfunction Using Machine Learning Algorithm Based on Vectorcardiography and Cardiodynamicsgram Features

Purpose: As a main etiology of myocardial ischemia, coronary microvascular dysfunction (CMD) can occur in patients with or without obstructive coronary artery disease. Currently, there is a lack of a non-invasive approach for early detection of CMD.Aim: We aim to develop a multilayer perceptron (MLP) algorithm to achieve non-invasive early detection of CMD based on vectorcardiography (VCG) and cardiodynamicsgram (CDG) features. Methods: Electrocardiograms of 82 CMD patients and 107 healthy controls were collected and synthesized into VCGs. The VCGs' ST-T segments were extracted and fed into a deterministic learning algorithm to develop CDGs. Temporal heterogeneity index, spatial heterogeneity index, sample entropy, approximate entropy, and complexity index were extracted from VCGs' ST-T segments and CDGs, entitled as STT- and CDG-based features, respectively. The most effective feature subsets were determined from CDG-based, STT-based, and the combined features (i.e., all features) via the sequential backward selection algorithm as inputs for CDG-, STT-, and CDG-STT-based MLP models optimized with an improved sparrow search algorithm, respectively. Finally, the classification capacity of the corresponding models was evaluated via five-fold cross-validations and tested on a testing dataset to verify the optimal one.Results: The CDG-STT-based MLP model had significantly higher evaluated metrics than CDG-and STT-based ones on the validation dataset, with the accuracy, sensitivity, specificity, F1 score, and AUC of 0.904, 0.925, 0.870, 0.870, and 0.897 on the testing dataset respectively.Conclusions: The MLP model based on VCG and CDG features showed high efficiency in identifying CMD. The CDG-STT-based MLP model may afford a potential computer-aided tool for non-invasive detection of CMD.(c) 2023 AGBM. Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons .org /licenses/by-nc-nd/4.0/).