Deyun Zhang
Publications
Artificial intelligence-enabled single-lead ECG for non-invasive hyperkalemia detection: development, multicenter validation, and proof-of-concept deployment
Hyperkalemia is a life-threatening electrolyte disorder that is common in patients with chronic kidney disease and heart failure, yet frequent monitoring remains difficult outside hospital settings. We developed and validated Pocket-K, a single-lead AI-ECG system initialized from the ECGFounder foundation model for non-invasive hyperkalemia screening and handheld deployment. In this multicentre observational study using routinely collected clinical ECG and laboratory data, 34,439 patients contributed 62,290 ECG--potassium pairs. Lead I data were used to fine-tune the model. Data from Peking University People's Hospital were divided into development and temporal validation sets, and data from The Second Hospital of Tianjin Medical University served as an independent external validation set. Hyperkalemia was defined as venous serum potassium > 5.5 mmol/L. Pocket-K achieved AUROCs of 0.936 in internal testing, 0.858 in temporal validation, and 0.808 in external validation. For KDIGO-defined moderate-to-severe hyperkalemia (serum potassium >= 6.0 mmol/L), AUROCs increased to 0.940 and 0.861 in the temporal and external sets, respectively. External negative predictive value exceeded 99.3%. Model-predicted high risk below the hyperkalemia threshold was more common in patients with chronic kidney disease and heart failure. A handheld prototype enabled near-real-time inference, supporting future prospective evaluation in native handheld and wearable settings.
ECGomics: An Open Platform for AI-ECG Digital Biomarker Discovery
Background: Conventional electrocardiogram (ECG) analysis faces a persistent dichotomy: expert-driven features ensure interpretability but lack sensitivity to latent patterns, while deep learning offers high accuracy but functions as a black box with high data dependency. We introduce ECGomics, a systematic paradigm and open-source platform for the multidimensional deconstruction of cardiac signals into digital biomarker. Methods: Inspired by the taxonomic rigor of genomics, ECGomics deconstructs cardiac activity across four dimensions: Structural, Intensity, Functional, and Comparative. This taxonomy synergizes expert-defined morphological rules with data-driven latent representations, effectively bridging the gap between handcrafted features and deep learning embeddings. Results: We operationalized this framework into a scalable ecosystem consisting of a web-based research platform and a mobile-integrated solution (https://github.com/PKUDigitalHealth/ECGomics). The web platform facilitates high-throughput analysis via precision parameter configuration, high-fidelity data ingestion, and 12-lead visualization, allowing for the systematic extraction of biomarkers across the four ECGomics dimensions. Complementarily, the mobile interface, integrated with portable sensors and a cloud-based engine, enables real-time signal acquisition and near-instantaneous delivery of structured diagnostic reports. This dual-interface architecture successfully transitions ECGomics from theoretical discovery to decentralized, real-world health management, ensuring professional-grade monitoring in diverse clinical and home-based settings. Conclusion: ECGomics harmonizes diagnostic precision, interpretability, and data efficiency. By providing a deployable software ecosystem, this paradigm establishes a robust foundation for digital biomarker discovery and personalized cardiovascular medicine.
AnyECG: Evolved ECG Foundation Model for Holistic Health Profiling
Background: Artificial intelligence enabled electrocardiography (AI-ECG) has demonstrated the ability to detect diverse pathologies, but most existing models focus on single disease identification, neglecting comorbidities and future risk prediction. Although ECGFounder expanded cardiac disease coverage, a holistic health profiling model remains needed. Methods: We constructed a large multicenter dataset comprising 13.3 million ECGs from 2.98 million patients. Using transfer learning, ECGFounder was fine-tuned to develop AnyECG, a foundation model for holistic health profiling. Performance was evaluated using external validation cohorts and a 10-year longitudinal cohort for current diagnosis, future risk prediction, and comorbidity identification. Results: AnyECG demonstrated systemic predictive capability across 1172 conditions, achieving an AUROC greater than 0.7 for 306 diseases. The model revealed novel disease associations, robust comorbidity patterns, and future disease risks. Representative examples included high diagnostic performance for hyperparathyroidism (AUROC 0.941), type 2 diabetes (0.803), Crohn disease (0.817), lymphoid leukemia (0.856), and chronic obstructive pulmonary disease (0.773). Conclusion: The AnyECG foundation model provides substantial evidence that AI-ECG can serve as a systemic tool for concurrent disease detection and long-term risk prediction.