Adedinsewo AI-ECG (peripartum cardiomyopathy)

Artificial Intelligence Guided Screening for Cardiomyopathies in an Obstetric Population: a Pragmatic Randomized Clinical Trial

Paziente / Popolazione Intervento / Esposizione Confronto Esito

In 1,232 pregnant and postpartum women at 6 hospitals in Nigeria, AI-guided screening with a digital stethoscope and a 12-lead AI-ECG improved identification of left ventricular systolic dysfunction compared with usual care.

N
1232
Disegno
Open-label pragmatic RCT, Nigeria (6 hospitals)
Esito
Identification of left ventricular systolic dysfunction during the study period
Rilevanza
2
RisultatoAI digital stethoscope: LVSD identified in 4.1% (24/587) vs 2.0% (12/608) (OR 2.12, 95% CI 1.05–4.27; P=0.032); 12-lead AI-ECG: 3.4% (20/587) vs 2.0% (OR 1.75, 95% CI 0.85–3.62; P=0.125). 1,195 of 1,232 randomised completed the baseline visit; no serious adverse events.
Adedinsewo DA, et al. Nat Med. 2024;30(10):2897-2906. 10.1038/s41591-024-03243-9
Discussione e critica

The first randomised trial of AI screening in pregnancy, run in the country with the highest reported incidence of peripartum cardiomyopathy and a rare AI trial in a low-resource setting. Only the digital-stethoscope model reached significance; the 12-lead AI-ECG did not. The endpoint is detection rather than maternal outcome, the trial was open-label, and the intervention arm had a baseline confirmatory echocardiogram that the control arm did not, which favours detection in that arm.