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Despite guideline recommendations, only half of the patients undergo surveillance echocardiograms. An AI model detecting reduced left ventricular ejection fraction from 12-lead electrocardiograms (ECG) (AI-EF model) suggests ECG features reflect left ventricular pathophysiology. We hypothesized that AI could predict CTRCD from baseline ECG, leveraging the AI-EF model\u2019s insights, and developed the AI-CTRCD model using transfer learning on the AI-EF model. In 1011 anthracycline-treated patients, 8.7% experienced CTRCD. High AI-CTRCD scores indicated elevated CTRCD risk (hazard ratio (HR), 2.66; 95% CI 1.73\u20134.10; log-rank\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). This remained consistent after adjusting for risk factors (adjusted HR, 2.57; 95% CI 1.62\u20134.10;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). AI-CTRCD score enhanced prediction beyond known factors (time-dependent AUC for 2 years: 0.78 with AI-CTRCD score vs. 0.74 without;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). In conclusion, the AI model robustly stratified CTRCD risk from baseline ECG.\n                  <\/jats:p>","DOI":"10.1038\/s41467-024-45733-x","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T13:01:46Z","timestamp":1711026106000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["Artificial intelligence-enabled prediction of chemotherapy-induced cardiotoxicity from baseline electrocardiograms"],"prefix":"10.1038","volume":"15","author":[{"given":"Ryuichiro","family":"Yagi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0450-0331","authenticated-orcid":false,"given":"Shinichi","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Himeno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Katsumata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5181-2664","authenticated-orcid":false,"given":"Calum A.","family":"MacRae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2791-9434","authenticated-orcid":false,"given":"Rahul C.","family":"Deo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"45733_CR1","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1056\/NEJM199103213241210","volume":"324","author":"JH Doroshow","year":"1991","unstructured":"Doroshow, J. 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