Tensor-based Multimodal Learning for Prediction of Pulmonary Arterial Wedge Pressure from Cardiac MRI

TL;DR

This paper introduces a tensor learning pipeline that combines multimodal cardiac MRI and electronic health records to non-invasively predict pulmonary arterial wedge pressure, showing significant improvements over baseline methods in a large patient cohort.

Contribution

The study develops a novel tensor-based multimodal learning approach with quality control and data integration for predicting PAWP from cardiac MRI and health records.

Findings

Achieved a 0.10 increase in AUC over baseline

Improved accuracy by 0.06 compared to existing methods

Demonstrated clinical utility through decision curve analysis

Abstract

Heart failure is a serious and life-threatening condition that can lead to elevated pressure in the left ventricle. Pulmonary Arterial Wedge Pressure (PAWP) is an important surrogate marker indicating high pressure in the left ventricle. PAWP is determined by Right Heart Catheterization (RHC) but it is an invasive procedure. A non-invasive method is useful in quickly identifying high-risk patients from a large population. In this work, we develop a tensor learning-based pipeline for identifying PAWP from multimodal cardiac Magnetic Resonance Imaging (MRI). This pipeline extracts spatial and temporal features from high-dimensional scans. For quality control, we incorporate an epistemic uncertainty-based binning strategy to identify poor-quality training samples. To improve the performance, we learn complementary information by integrating features from multimodal data: cardiac MRI with short-axis and four-chamber views, and Electronic Health Records. The experimental analysis on a large cohort of $1346$ subjects who underwent the RHC procedure for PAWP estimation indicates that the proposed pipeline has a diagnostic value and can produce promising performance with significant improvement over the baseline in clinical practice (i.e., $\Delta$AUC $=0.10$, $\Delta$Accuracy $=0.06$, and $\Delta$MCC $=0.39$). The decision curve analysis further confirms the clinical utility of our method.