Aim. To assess the prospects of using artificial intelligence technologies in predicting the outcomes and risks of cardiovascular diseases (CVD) in patients with hypertension (HTN).Material and methods. A software application was created for data mining from respondent profiles in a semi-automatic mode; libraries with data preprocessing were analyzed. We analyzed the main and additional parameters (35) of CVD risk factors in 2131 people as a part of ESSE-RF study (2014-2019). To create a forecasting model, a high-level language Python 2.7 was used using object-oriented programming and exception handling with multithreading support. Using randomization, learning (n=488) and test (n=245) samples were formed, which included data from patients with an established diagnosis of HTN.Results. The prevalence of HTN among subjects was 34,39%. There were following significant factors for predicting CVD: anthropometric parameters, smoking, biochemical profile (total cholesterol, ApoA, ApoB, glucose, D-dimer, C-reactive protein). As a result of a 5-year follow-up, CVD was found in 235 people (32,06%) with HTN and 187 people (13,38%) without HTN; mortality rates were 1,27% in subjects with HTN and 1,12% — without HTN. The absolute mortality risk among participants with HTN (0,037) was significantly higher (p<0,05) than in patients without HTN (0,017). To create a neural network (NN), the basic Sequential model from the Keras library was used. During machine learning, 26 variables important for the CVD development were used as input and 9 neurons — as output, which corresponded to the number of established cardiovascular events. The created NN had a predictive value of up to 97,9%, which exceeded the SCORE value (34,9%).Conclusion. The data obtained indicate the importance of risk factor phenotyping using anthropometric markers and biochemical profile for determining their significance in the top 20 predictors of CVD. The Python-based machine learning provides CVD prediction according to standard risk assessments.
Chronic obstructive pulmonary disease (COPD) is considered a typical model of accelerated aging due to the variability and systemic nature of its manifestations. The leading factor in tissue remodeling in COPD is a change or reprogramming of the cellular metabolism in response to external factors such as tobacco combustion products, biofuels, viruses, etc. Mitochondrial biology dominates the spectrum of mechanisms of tissue and cellular reprogramming in COPD. Being parasymbiotic organelles, mitochondria have a complex system of interaction with other cells of the human body and participate in both biogenesis, or formation of new organelles, and mitophagy, or elimination of defective mitochondria by the host cell. Both of these mechanisms are dysregulated in COPD.The aim of this work is to combine the accumulated research experience in the field of cellular metabolism and the role of mitochondria for in-depth COPD phenotyping depending on the metabolic reprogramming variants and for development of new therapeutic possibilities to correct the reprogramming.Conclusion. Mitochondria are key regulators of metabolism, redox homeostasis, cell survival and proliferation. These processes are controlled by various intra- and intercellular signaling pathways and reflect the COPD-associated imbalance at the level of various tissue lineages: alveolocytes, epithelial cells of the lung tissue, smooth myocytes of the respiratory tract, alveolar macrophages, striated muscle cells, mesenchymal stromal cells, progenitor cells, etc. The studies of metabolome and mitochondrial function pointed out where to look for new therapeutic options for COPD.
Aim. To develop and perform comparative assessment of the accuracy of models for predicting 5-year mortality risks according to the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study in Primorsky Krai.Material and methods. The study included 2131 people (1257 women and 874 men) aged 23-67 years with a median of 47 years (95% confidence interval [46; 48]). The study protocol included measurement of blood pressure (BP), heart rate (HR), waist circumference, hip circumference, and waist-to-hip ratio (WHR). The following blood biochemical parameters: total cholesterol (TC), low and high density lipoprotein cholesterol, triglycerides, apolipoproteins AI and B, lipoprotein(a), N-terminal pro-brain natriuretic peptide (NT-proNBP), D-dimer, fibrinogen, C-reactive protein (CRP), glucose, creatinine, uric acid. The study endpoint was 5-year all-cause death (2013-2018). The group of deceased patients during this period consisted of 42 (2%) people, while those continued the study — 2089 (98%). The χ2, Fisher and MannWhitney tests, univariate logistic regression (LR) were used for data processing and analysis. To build predictive models, we used following machine learning (ML) methods: multivariate LR, Weibull regression, and stochastic gradient boosting.Results. The prognostic models developed on the ML basis, using parameters of age, sex, smoking, systolic blood pressure (SBP) and TC level in their structure, had higher quality metrics than Systematic COronary Risk Evaluation (SCORE) system. The inclusion of CRP, glucose, NT-proNBP, and heart rate into the predictors increased the accuracy of all models with the maximum rise in quality metrics in the multivariate LR model. Predictive potential of other factors (WHR, lipid profile, fibrinogen, D-dimer, etc.) was low and did not improve the prediction quality. An analysis of the influence degree of individual predictors on the mortality rate indicated the prevailing contribution of five factors as follows: age, levels of TC, NT-proNBP, CRP, and glucose. A less noticeable effect was associated with the level of HR, SBP and smoking, while the contribution of sex was minimal.Conclusion. The use of modern ML methods increases the accuracy of predictive models and provides a higher efficiency of risk stratification, especially among individuals with a low and moderate death risk from cardiovascular diseases.
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