Predicting Left Ventricular Mass Using ECG, Demographic and DXA Features

Jonathan Moeyersons1, Ruben De Bosscher2, Christophe Dausin3, Guido Claessen2, André La Gerche4, Jan Bogaert2, Rik Willems2, Sabine Van Huffel3, Carolina Varon5
1ESAT-STADIUS, KU Leuven, 2University Hospitals of Leuven, 3KU Leuven, 4University of Melbourne, 5Delft University of Technology


The term “athlete’s heart” describes the adaptation of the left ventricle (LV) to long-term, intensive training, with an increase in LV mass (LVM) as one of the primary features. Distinguishing this physiological adaptation from concentric hypertrophic cardiomyopathy is challenging.

The gold standard for the assessment of cardiac mass is cardiac magnetic resonance imaging (CMR). However, it is costly and requires specific expertise. Electrocardiographic (ECG) criteria could provide a low-cost solution, but have shown to be poorly correlated with LVM in athletes. We hypothesize that this poor correlation could be overcome by taking into account body measurements (length, weight) and composition (fat mass, lean mass and bone mass).

The objective was to assess whether adding demographic (Demo) and/or Dual-energy X-ray absorptiometry (DXA) features could improve an ECG-based regression model for the estimation of LVM in athletes.

107 young competitive endurance athletes (19±2 years; 35 female) underwent a 12-lead ECG, a DXA scan and CMRI. We constructed four feature subsets: ECG, ECG+Demo, ECG+DXA and All. The best combination of features from each set, was used to build a Support Vector Machines regression model with 5 features.

The ECG model performed significantly worse than all other models (R2 = 0.28 (0.17), RMSE = 34.33 (5.63) g). The best performing model was constructed with the entire feature set ((R2 = 0.67 (0.14), RMSE = 23.08 (4.42) g).

These results suggest that an ECG based regression model for LVM prediction can be improved by adding demographic and/or body composition features.