Comparison of Electrocardiographic Parameters by Gender in Heart Failure Patients with Preserved Ejection Fraction via Artificial Intelligence

Background: Heart failure (HF) causes high morbidity and mortality worldwide. The prevalence of HF with preserved ejection fraction (HFpEF) is increasing compared with HF with reduced ejection fraction (HFrEF). Patients with HFpEF are a patient group with a high rate of hospitalization despite medical treatment. Early diagnosis is very important in this group of patients, and early treatment can improve their prognosis. Although electrocardiographic (ECG) findings have been adequately studied in patients with HFrEF, there are not enough studies on these parameters in patients with HFpEF. There are very few studies in the literature, especially on gender-specific changes. The current research aims to compare gender-specific ECG parameters in patients with HFpEF based on the implications of artificial intelligence (AI). Methods: A total of 118 patients participated in the study, of which 66 (56%) were women with HFpEF and 52 (44%) were men with HFpEF. Demographic, echocardiographic, and electrocardiographic characteristics of the patients were analyzed to compare gender-specific ECG parameters in patients with HFpEF. The AI approach combined with machine learning approaches (gradient boosting machine, k-nearest neighbors, logistic regression, random forest, and support vector machines) was applied for distinguishing male patients with HFpEF from female patients with HFpEF. Results: After determining the parameters (demographic, echocardiographic, and electrocardiographic) to distinguish male patients with HFpEF from female patients with HFpEF, machine learning methods were applied, and among these methods, the random forest model achieved an average accuracy of 84.7%. The random forest algorithm results showed that smoking, P-wave dispersion, P-wave amplitude, T-end P/(PQ*Age), Cornell product, and P-wave duration were the most influential parameters for distinguishing male patients with HFpEF from female patients with HFpEF. Conclusions: The proposed model serves as a valuable tool for physicians, facilitating the diagnosis, treatment, and follow-up for distinguishing male patients with HFpEF from female patients with HFpEF. Analyzing readily accessible electrocardiographic parameters empowers medical professionals to make informed decisions and provide enhanced care to a wide range of individuals.