{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:38:40Z","timestamp":1792636720420,"version":"4.5.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"HeartForce Medical Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Coronary artery disease (CAD) remains a leading cause of morbidity. Existing clinical likelihood models often lack specificity, contributing to unnecessary diagnostic testing. To develop, train, and validate the electro-mechanical risk (EMR) Score. This machine learning model uses cardiac mechanical information from resting seismocardiography (SCG) recordings and patient-level clinical risk factors to estimate obstructive CAD likelihood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This multi-centre clinical study included 2110 adults. Resting SCG was recorded using a sternum accelerometer. Obstructive CAD was defined as 50% or greater stenosis on coronary computed tomography angiography or invasive coronary angiography. A one-dimensional convolutional neural network was trained to compute the EMR Score. Performance was evaluated using repeated cross-validation and external-centre validation and compared with the 2024 ESC Risk-Factor\u2013weighted Clinical Likelihood (RF-CL) model. Among 2110 participants (mean [SD] age, 57.8 [10.3] years; 801 women [38%]), 760 had obstructive CAD. In symptomatic individuals, the EMR Score achieved an AUC of 0.88, outperforming RF-CL (AUC, 0.85; P = 0.023), with higher specificity (53% vs. 35%) and comparable sensitivity (94% vs. 97%). In external-centre validation, the EMR Score achieved an AUC of 0.91, sensitivity of 97.8%, specificity of 52.0%, PPV of 78.0%, and NPV of 93.0%. In asymptomatic participants, the AUC was 0.89. The EMR Score classified 23% of the cohort as very low likelihood, with 2% CAD prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The EMR Score non-invasively estimated obstructive CAD likelihood, with external-centre validation supporting generalizability beyond internal cross-validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov (NCT06880120, NCT06880133)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztag139","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T11:44:05Z","timestamp":1787399045000},"source":"Crossref","is-referenced-by-count":0,"title":["Electro-mechanical risk score for coronary artery disease risk estimation using seismocardiography"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5053-317X","authenticated-orcid":false,"given":"Parastoo","family":"Dehkordi","sequence":"first","affiliation":[{"name":"HeartForce Medical Inc. Research and Development Department, , 1201-570 Granville Street, Vancouver, BC V6C 1W6 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouhyar","family":"Tavakolian","sequence":"additional","affiliation":[{"name":"University of North Dakota Biomedical Engineering Department, , ND ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Rocco","sequence":"additional","affiliation":[{"name":"University of Rochester Department of Medicine, , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khurshid","family":"Fozilov","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Medical Center of Cardiology Interventional Cardiology Department, , Tashkent ,","place":["Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisher","family":"Yuldashov","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Medical Center of Cardiology Interventional Cardiology Department, , Tashkent ,","place":["Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4146-420X","authenticated-orcid":false,"given":"Wojciech","family":"Zareba","sequence":"additional","affiliation":[{"name":"University of Rochester Department of Medicine, , New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baxtiyorjon","family":"Yuldashov","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Medical Center of Cardiology Interventional Cardiology Department, , Tashkent ,","place":["Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baxtiyor","family":"Atamuratov","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Medical Center of Cardiology Interventional Cardiology Department, , Tashkent ,","place":["Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4408-2397","authenticated-orcid":false,"given":"Hamid R","family":"Marateb","sequence":"additional","affiliation":[{"name":"Polytechnic University of Catalonia Research Center for Biomedical Engineering, , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shukhrat","family":"Doniyorov","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Medical Center of Cardiology Interventional Cardiology Department, , Tashkent ,","place":["Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernara","family":"Kurbanova","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Medical Center of Cardiology Interventional Cardiology Department, , Tashkent ,","place":["Uzbekistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzad","family":"Khosrow-Khavar","sequence":"additional","affiliation":[{"name":"HeartForce Medical Inc. Research and Development Department, , 1201-570 Granville Street, Vancouver, BC V6C 1W6 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"2026102121520480100_ztag139-B1","volume-title":"Global Health Estimates 2021: Deaths by Cause, Age, Sex, by Country and by Region, 2000\u20132021","author":"World Health Organization","year":"2024"},{"key":"2026102121520480100_ztag139-B2","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/eurheartj\/ehz425","article-title":"2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes: the task force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC)","volume":"41","author":"Knuuti","year":"2020","journal-title":"Eur Heart J"},{"key":"2026102121520480100_ztag139-B3","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC guidelines for the management of chronic coronary syndromes","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur Heart J"},{"key":"2026102121520480100_ztag139-B4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jcct.2016.11.003","article-title":"2016 SCCT\/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans","volume":"11","author":"Hecht","year":"2017","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2026102121520480100_ztag139-B5","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1016\/j.jacc.2020.09.585","article-title":"Incorporating coronary calcification into pre-test assessment of the likelihood of coronary artery disease","volume":"76","author":"Winther","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026102121520480100_ztag139-B6","first-page":"87","article-title":"The method of seismocardiography","volume":"18","author":"Baevskii","year":"1964","journal-title":"Kardiologiia"},{"key":"2026102121520480100_ztag139-B7","first-page":"111","article-title":"Seismocardiography: a new technique for recording cardiac vibrations. 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