ECG and CXR for Predicting Cardiovascular Diseases

May 1, 2026 updated by: Shanghai Zhongshan Hospital

A Retrospective Cohort Study of Multimodal Electrocardiography and Chest Radiography for Prediction of Progression to Moderate or Severe Regurgitant Valvular Heart Disease

This retrospective multicenter cohort study aims to develop and validate an artificial intelligence model integrating electrocardiography (ECG) and chest radiography (CXR) to predict future progression of regurgitant valvular heart disease (rVHD), including aortic, mitral, and tricuspid regurgitation. Adult patients with ECG, CXR, and echocardiography obtained within 60 days, together with follow-up echocardiographic data, are included. The primary objective is to determine whether multimodal ECG+CXR modeling improves prediction of progression to moderate or severe regurgitation beyond ECG-only or CXR-only models. Secondary objectives include evaluation of clinical utility, risk stratification, and model interpretability. This study is intended to assess whether routinely acquired ECG and CXR can be used to support surveillance echocardiography and risk-directed management in patients at risk of future rVHD progression.

Study Overview

Status

Completed

Conditions

Study Type

Observational

Enrollment (Actual)

116380

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, China, 200032
        • Zhongshan Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

This study population was a retrospective multicenter, echo-phenotyped longitudinal cohort derived from routine clinical care. The development cohort was obtained from Zhongshan Hospital, Shanghai, China, and included consecutive adult patients receiving care between July 14, 2017 and December 31, 2023. An external validation cohort was obtained from a second center using the same eligibility framework. The cohort was anchored to routinely acquired ECG and CXR, with baseline echocardiography used to define prevalent valvular status and follow-up echocardiography used to determine progression to clinically significant regurgitant valvular heart disease.

Description

Inclusion Criteria:

Adult patients aged ≥18 years. Underwent routine electrocardiography (ECG), chest radiography (CXR), and echocardiography within 60 days.

Had subsequent follow-up echocardiographic data available for outcome ascertainment.

Patients were identified from routine clinical practice in inpatient admission or outpatient evaluation settings.

Exclusion Criteria:

Age below the adult threshold. Missing any of the required baseline examinations (ECG, CXR, or echocardiography within 60 days).

No follow-up echocardiographic data available. For future-risk evaluation in the test cohort, samples with moderate or severe regurgitation at baseline were excluded.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incident Regurgitant Valvular Heart Disease
Time Frame: Up to 5 years
Incident regurgitant valvular heart disease was defined as new progression to moderate or severe aortic regurgitation, mitral regurgitation, or tricuspid regurgitation on follow-up echocardiography after the index ECG-CXR assessment. For each target valve, patients with no or mild regurgitation at baseline were considered at risk, and the first follow-up echocardiographic examination showing moderate or severe regurgitation was considered an incident event.
Up to 5 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Shanghai Zhongshan Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 14, 2017

Primary Completion (Actual)

December 31, 2023

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

May 1, 2026

First Submitted That Met QC Criteria

May 1, 2026

First Posted (Actual)

May 7, 2026

Study Record Updates

Last Update Posted (Actual)

May 7, 2026

Last Update Submitted That Met QC Criteria

May 1, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • B2024-497

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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