AI modeling photoplethysmography to electrocardiography useful for predicting cardiovascular disease
Cardiovascular diseases (CVDs) remain the leading cause of global mortality, with early detection critical for improving patient outcomes. Photoplethysmography (PPG) is a widely used, non-invasive signal in both clinical monitors and consumer wearables; however, noise susceptibility and the absence of direct electrophysiological markers limit its utility across home and clinical settings. We present CardioPPG, a cross-modal learning framework that augments PPG with ECG-derived representations to improve CVD prediction and enable ECG synthesis for interpretability. Through cross-modal contrastive learning, CardioPPG aligns PPG and ECG features in a shared latent space, followed by an autoregressive generative model that synthesizes high-quality ECG signals. Extensive evaluations show that CardioPPG surpasses a PPG-only self-supervised baseline across multiple CVDs screening-including mitral and aortic valvular disease, atrial fibrillation, cardiomyopathy, and paroxysmal supraventricular tachycardia, among others-with relative AUC gains over the baseline of 41.3%, 12.2%, 8.8%, and 30.3%, respectively. On an external atrial-fibrillation dataset with 86 samples, CardioPPG achieved high AUCs of 99.5% and 98.6% on two PPG channels, confirming the model's generalizability. Furthermore, it generates ECG signals whose distributions closely match those of authentic ECGs, enhancing the interpretability. CardioPPG offers a scalable, real-time, non-invasive solution for CVD monitoring, with significant potential for use in-home settings and resource-limited environments, thus facilitating early detection and timely intervention.
Authors
- Yiheng Mao (ORCID: https://orcid.org/0000-0001-8314-7929)
- Xuesen Chu (ORCID: https://orcid.org/0000-0002-9540-5961)
- Dongchen Zhou (ORCID: https://orcid.org/0000-0003-1923-9671)
- Hongkun Zhang (ORCID: https://orcid.org/0000-0003-1762-8614)
- Qingbo Xu (ORCID: https://orcid.org/0000-0002-6414-2273)
- Zhengxing Huang (ORCID: https://orcid.org/0000-0002-2644-8642)
- Haitao Li (ORCID: https://orcid.org/0000-0003-1621-4751)
- Ziyi Liu (ORCID: https://orcid.org/0000-0002-2460-6782)
- Ting Chen (ORCID: https://orcid.org/0000-0002-3228-9166)
- Yu Long
- Yujian Hu
- Zhengyao Ding (ORCID: https://orcid.org/0009-0008-7230-0009)
- Fei Wu (ORCID: https://orcid.org/0000-0002-3415-3203)
- Ziyu Li (ORCID: https://orcid.org/0000-0002-5402-8071)
Institutions
- Zhejiang University of Science and Technology (CN)
- China Mobile (China) (CN)
- Wuhan Ship Development & Design Institute (CN)
- First Affiliated Hospital Zhejiang University (CN)
- Zhejiang University of Technology (CN)
Publication Details
- Journal
- npj Digital Medicine
- Published
- 2025-12-14
- DOI
- https://doi.org/10.1038/s41746-025-02228-3
- Primary Topic
- Non-Invasive Vital Sign Monitoring
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Natural Science Foundation of China
- Zhejiang University