{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:25:47Z","timestamp":1793157947555,"version":"4.5.0"},"reference-count":38,"publisher":"Japanese Circulation Society","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Circ J"],"published-print":{"date-parts":[[2025,9,25]]},"DOI":"10.1253\/circj.cj-25-0098","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T18:07:25Z","timestamp":1750097245000},"page":"1684-1692","source":"Crossref","is-referenced-by-count":15,"title":["Deep Learning for Cardiac Overload Estimation\u3000\u2015 Predicting B-Type Natriuretic Peptide (BNP) Levels From Heart Sounds and Electrocardiogram \u2015"],"prefix":"10.1253","volume":"89","author":[{"given":"Shimpei","family":"Ogawa","sequence":"first","affiliation":[{"name":"AMI Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University"},{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumpei","family":"Saito","sequence":"additional","affiliation":[{"name":"AMI Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Seki","sequence":"additional","affiliation":[{"name":"AMI Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koshiro","family":"Ikeda","sequence":"additional","affiliation":[{"name":"AMI Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhei","family":"Yasui","sequence":"additional","affiliation":[{"name":"AMI Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Komatsu","sequence":"additional","affiliation":[{"name":"AMI Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginga","family":"Sato","sequence":"additional","affiliation":[{"name":"AMI Inc."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Tabata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Ohishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuro","family":"Kubozono","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naritatsu","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eri Toda","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Hospital"},{"name":"Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyoto University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Natori","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hokkaido Social Work Association Furano Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Kunikane","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hokkaido Social Work Association Furano Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Yokomatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mitsubishi Kyoto Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mitsubishi Kyoto Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuaki","family":"Sagara","sequence":"additional","affiliation":[{"name":"Department of Breast Surgical Oncology, Sagara Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nami","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sagara Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Atsuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tenyokai Central Hospital and Central Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Kajiki Onsen Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Natsugoe","sequence":"additional","affiliation":[{"name":"Kajiki Onsen Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Tsujita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"330","reference":[{"key":"1","doi-asserted-by":"publisher","unstructured":"1. Foroutan F, Rayner DG, Ross HJ, Ehler T, Srivastava A, Shin S, et al. Global comparison of readmission rates for patients with heart failure. <i>J Am Coll Cardiol<\/i> 2023; 82: 430\u2013444, doi:10.1016\/j.jacc.2023.05.040.","DOI":"10.1016\/j.jacc.2023.05.040"},{"key":"2","doi-asserted-by":"publisher","unstructured":"2. Shiraishi Y, Kohsaka S, Sato N, Takano T, Kitai T, Yoshikawa T, et al. 9-year trend in the management of acute heart failure in Japan: A report from the National Consortium of Acute Heart Failure Registries. <i>JAHA<\/i> 2018; 7: e008687, doi:10.1161\/JAHA.118.008687.","DOI":"10.1161\/JAHA.118.008687"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Okura Y, Ramadan MM, Ohno Y, Mitsuma W, Tanaka K, Ito M, et al. Impending epidemic future projection of heart failure in Japan to the year 2055: Future projection of heart failure in Japan to the year 2055. <i>Circ J<\/i> 2008; 72: 489\u2013491, doi:10.1253\/circj.72.489.","DOI":"10.1253\/circj.72.489"},{"key":"4","doi-asserted-by":"publisher","unstructured":"4. Ledwidge M, Gallagher J, Conlon C, Tallon E, O\u2019Connell E, Dawkins I, et al. Natriuretic peptide-based screening and collaborative care for heart failure: The STOP-HF randomized trial. <i>JAMA<\/i> 2013; 310: 66, doi:10.1001\/jama.2013.7588.","DOI":"10.1001\/jama.2013.7588"},{"key":"5","doi-asserted-by":"publisher","unstructured":"5. Fitchett D, Butler J, van de Borne P, Zinman B, Lachin JM, Wanner C, et al. Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrum of heart failure risk in the EMPA-REG OUTCOME\u00ae trial. <i>Eur Heart J<\/i> 2018; 39: 363\u2013370, doi:10.1093\/eurheartj\/ehx511.","DOI":"10.1093\/eurheartj\/ehx511"},{"key":"6","doi-asserted-by":"publisher","unstructured":"6. McMurray JJV, Solomon SD, Inzucchi SE, K\u00f8ber L, Kosiborod MN, Martinez FA, et al. Dapagliflozin in patients with heart failure and reduced ejection fraction. <i>N Engl J Med<\/i> 2019; 381: 1995\u20132008, doi:10.1056\/NEJMoa1911303.","DOI":"10.1056\/NEJMoa1911303"},{"key":"7","doi-asserted-by":"publisher","unstructured":"7. Tsutsui H, Isobe M, Ito H, Ito H, Okumura K, Ono M, et al. JCS 2017\/JHFS 2017 Guideline on diagnosis and treatment of acute and chronic heart failure: Digest version. <i>Circ J<\/i> 2019; 83: 2084\u20132184, doi:10.1253\/circj.CJ-19-0342.","DOI":"10.1253\/circj.CJ-19-0342"},{"key":"8","doi-asserted-by":"publisher","unstructured":"8. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA\/ACC\/HFSA Guideline for the management of heart failure: A report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. <i>Circulation<\/i> 2022; 145: e895\u2013e1032, doi:10.1161\/CIR.0000000000001063.","DOI":"10.1161\/CIR.0000000000001063"},{"key":"9","doi-asserted-by":"publisher","unstructured":"9. Bozkurt B, Coats AJ, Tsutsui H, Abdelhamid M, Adamopoulos S, Albert N, et al. Universal Definition and Classification of Heart Failure: A Report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. <i>J Card Fail<\/i> 2021; S1071-9164(21)00050-6, doi:10.1016\/j.cardfail.2021.01.022.","DOI":"10.1016\/j.cardfail.2021.01.022"},{"key":"10","doi-asserted-by":"publisher","unstructured":"10. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, B\u00f6hm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. <i>Eur Heart J<\/i> 2021; 42: 3599\u20133726, doi:10.1093\/eurheartj\/ehab368.","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"11","doi-asserted-by":"publisher","unstructured":"11. Anand IS, Fisher LD, Chiang YT, Latini R, Masson S, Maggioni AP, et al. Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial (Val-HeFT). <i>Circulation<\/i> 2003; 107: 1278\u20131283, doi:10.1161\/01.cir.0000054164.99881.00.","DOI":"10.1161\/01.CIR.0000054164.99881.00"},{"key":"12","doi-asserted-by":"publisher","unstructured":"12. Masson S, Latini R, Anand IS, Vago T, Angelici L, Barlera S, et al. Direct comparison of B-type natriuretic peptide (BNP) and amino-terminal proBNP in a large population of patients with chronic and symptomatic heart failure: The Valsartan Heart Failure (Val-HeFT) data. <i>Clin Chem<\/i> 2006; 52: 1528\u20131538, doi:10.1373\/clinchem.2006.069575.","DOI":"10.1373\/clinchem.2006.069575"},{"key":"13","doi-asserted-by":"publisher","unstructured":"13. Kagiyama N, Piccirilli M, Yanamala N, Shrestha S, Farjo PD, Casaclang-Verzosa G, et al. Machine learning assessment of left ventricular diastolic function based on electrocardiographic features. <i>J Am Coll Cardiol<\/i> 2020; 76: 930\u2013941, doi:10.1016\/j.jacc.2020.06.061.","DOI":"10.1016\/j.jacc.2020.06.061"},{"key":"14","doi-asserted-by":"publisher","unstructured":"14. Attia ZI, Noseworthy PA, Lopez-Jimenez F, Asirvatham SJ, Deshmukh AJ, Gersh BJ, et al. An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: A retrospective analysis of outcome prediction. <i>Lancet<\/i> 2019; 394: 861\u2013867, doi:10.1016\/S0140-6736(19)31721-0.","DOI":"10.1016\/S0140-6736(19)31721-0"},{"key":"15","doi-asserted-by":"publisher","unstructured":"15. Omori H, Kawase Y, Mizukami T, Tanigaki T, Hirata T, Okubo M, et al. Diagnostic accuracy of artificial intelligence-based angiography-derived fractional flow reserve using pressure wire-based fractional flow reserve as a reference. <i>Circ J<\/i> 2023; 87: 783\u2013790, doi:10.1253\/circj.CJ-22-0771.","DOI":"10.1253\/circj.CJ-22-0771"},{"key":"16","doi-asserted-by":"publisher","unstructured":"16. Yamamoto T, Sugizaki Y, Kawamori H, Toba T, Hiromasa T, Sasaki S, et al. Enhanced plaque stabilization effects of alirocumab: Insights From Artificial Intelligence-Aided Optical Coherence Tomography Analysis of the Alirocumab for Thin-Cap Fibroatheroma in Patients With Coronary Artery Disease Estimated by Optical Coherence Tomography (ALTAIR) Study. <i>Circ J<\/i> 2024; 88: 1809\u20131818, doi:10.1253\/circj.CJ-24-0480.","DOI":"10.1253\/circj.CJ-24-0480"},{"key":"17","doi-asserted-by":"publisher","unstructured":"17. Omori H, Kawase Y, Mizukami T, Tanigaki T, Hirata T, Okubo M, et al. Diagnostic performance of artificial intelligence-based angiography-derived non-hyperemic pressure ratio using pressure wire as reference. <i>Circ J<\/i> 2025; 89: 323\u20133304, doi:10.1253\/circj.CJ-24-0593.","DOI":"10.1253\/circj.CJ-24-0593"},{"key":"18","doi-asserted-by":"publisher","unstructured":"18. Abe Y, Ito M, Tanaka C, Ito K, Naruko T, Itoh A, et al. A novel and simple method using pocket-sized echocardiography to screen for aortic stenosis. <i>J Am Soc Echocardiogr<\/i> 2013; 26: 589\u2013596, doi:10.1016\/j.echo.2013.03.008.","DOI":"10.1016\/j.echo.2013.03.008"},{"key":"19","doi-asserted-by":"publisher","unstructured":"19. Sato Y, Kawasaki T, Honda S, Harimoto K, Miki S, Kamitani T, et al. Third and fourth heart sounds and myocardial fibrosis in hypertrophic cardiomyopathy. <i>Circ J<\/i> 2018; 82: 509\u2013516, doi:10.1253\/circj.CJ-17-0650.","DOI":"10.1253\/circj.CJ-17-0650"},{"key":"20","doi-asserted-by":"publisher","unstructured":"20. Marcus GM, Gerber IL, McKeown BH, Vessey JC, Jordan MV, Huddleston M, et al. Association between phonocardiographic third and fourth heart sounds and objective measures of left ventricular function. <i>JAMA<\/i> 2005; 293: 2238\u20132244, doi:10.1001\/jama.293.18.2238.","DOI":"10.1001\/jama.293.18.2238"},{"key":"21","doi-asserted-by":"publisher","unstructured":"21. Ogawa S, Namino F, Mori T, Sato G, Yamakawa T, Saito S. AI diagnosis of heart sounds differentiated with super StethoScope. <i>J Cardiol<\/i> 2024; 83: 265\u2013271, doi:10.1016\/j.jjcc.2023.09.007.","DOI":"10.1016\/j.jjcc.2023.09.007"},{"key":"22","unstructured":"22. Paszke A, Gross S, Massa F, Lerer A, Bradbury J, Chanan G, et al. PyTorch: An imperative style, high-performance deep learning library. <i>arXiv<\/i> 2019, doi:10.48550\/arXiv.1912.01703."},{"key":"23","unstructured":"23. Ke G, Meng Q, Finley T, Wang T, Chen W, Ma W, et al. LightGBM: A highly efficient gradient boosting decision tree. <i>In<\/i>: Proceedings of the 31st International Conference on Neural Information Processing Systems, Red Hook, NY, USA, 2017; 3149\u20133157."},{"key":"24","doi-asserted-by":"publisher","unstructured":"24. Mart\u00ednez JP, Almeida R, Olmos S, Rocha AP, Laguna P. A wavelet-based ECG delineator: Evaluation on standard databases. <i>IEEE Trans Biomed Eng<\/i> 2004; 51: 570\u2013581, doi:10.1109\/TBME.2003.821031.","DOI":"10.1109\/TBME.2003.821031"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Tang H, Dai Z, Jiang Y, Li T, Liu C. PCG classification using multidomain features and SVM classifier. <i>BioMed Res Int<\/i> 2018; 2018: 4205027, doi:10.1155\/2018\/4205027.","DOI":"10.1155\/2018\/4205027"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Selvaraju RR, Cogswell M, Das A, Vedantam R, Parikh D, Batra D. Grad-CAM: Visual explanations from deep networks via gradient-based localization. <i>arXiv<\/i> 2019, doi:10.48550\/arXiv.1610.02391.","DOI":"10.1007\/s11263-019-01228-7"},{"key":"27","doi-asserted-by":"publisher","unstructured":"27. Bhattacharya D, Sharma NK, Dutta D, Chetupalli SR, Mote P, Ganapathy S, et al. Coswara: A respiratory sounds and symptoms dataset for remote screening of SARS-CoV-2 infection. <i>Sci Data<\/i> 2023; 10: 397, doi:10.1038\/s41597-023-02266-0.","DOI":"10.1038\/s41597-023-02266-0"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Panayotov V, Chen G, Povey D, Khudanpur S. Librispeech: An ASR corpus based on public domain audio books. <i>In<\/i>: Proceedings of 2015 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP), 2015; 5206\u20135210, doi:10.1109\/ICASSP.2015.7178964.","DOI":"10.1109\/ICASSP.2015.7178964"},{"key":"29","doi-asserted-by":"publisher","unstructured":"29. Attia ZI, Kapa S, Lopez-Jimenez F, McKie PM, Ladewig DJ, Satam G, et al. Screening for cardiac contractile dysfunction using an artificial intelligence-enabled electrocardiogram. <i>Nat Med<\/i> 2019; 25: 70\u201374, doi:10.1038\/s41591-018-0240-2.","DOI":"10.1038\/s41591-018-0240-2"},{"key":"30","doi-asserted-by":"publisher","unstructured":"30. Hsiang CW, Lin C, Liu WC, Lin CS, Chang WC, Hsu HH, et al. Detection of left ventricular systolic dysfunction using an artificial intelligence-enabled chest X-ray. <i>Can J Cardiol<\/i> 2022; 38: 763\u2013773, doi:10.1016\/j.cjca.2021.12.019.","DOI":"10.1016\/j.cjca.2021.12.019"},{"key":"31","doi-asserted-by":"crossref","unstructured":"31. Iwanaga Y, Nishi I, Furuichi S, Noguchi T, Sase K, Kihara Y, et al. B-type natriuretic peptide strongly reflects diastolic wall stress in patients with chronic heart failure: Comparison between systolic and diastolic heart failure. <i>J Am Coll Cardiol<\/i> 2006; 47: 742\u2013748, doi:10.1016\/j.jacc.2005.11.030.","DOI":"10.1016\/j.jacc.2005.11.030"},{"key":"32","doi-asserted-by":"publisher","unstructured":"32. Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT. Does this dyspneic patient in the emergency department have congestive heart failure? <i>JAMA<\/i> 2005; 294: 1944\u20131956, doi:10.1001\/jama.294.15.1944.","DOI":"10.1001\/jama.294.15.1944"},{"key":"33","doi-asserted-by":"publisher","unstructured":"33. Kubo K, Hirata A, Kadota A, Harada A, Nakamura Y, Hayakawa T, et al. Risk factors for heart failure and coronary artery disease mortality based on the national vital statistics during a 25-year follow-up in Japan: NIPPON DATA90. <i>Circ J<\/i> 2024; 88: 1478\u20131487, doi:10.1253\/circj.CJ-23-0847.","DOI":"10.1253\/circj.CJ-23-0847"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Das SR, Drazner MH, Dries DL, Vega GL, Stanek HG, Abdullah SM, et al. Impact of body mass and body composition on circulating levels of natriuretic peptides: Results from the Dallas Heart Study. <i>Circulation<\/i> 2005; 112: 2163\u20132168, doi:10.1161\/CIRCULATIONAHA.105.555573.","DOI":"10.1161\/CIRCULATIONAHA.105.555573"},{"key":"35","doi-asserted-by":"publisher","unstructured":"35. Krauser DG, Lloyd-Jones DM, Chae CU, Cameron R, Anwaruddin S, Baggish AL, et al. Effect of body mass index on natriuretic peptide levels in patients with acute congestive heart failure: A ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy. <i>Am Heart J<\/i> 2005; 149: 744\u2013750, doi:10.1016\/j.ahj.2004.07.010.","DOI":"10.1016\/j.ahj.2004.07.010"},{"key":"36","doi-asserted-by":"publisher","unstructured":"36. Sugisawa T, Kishimoto I, Kokubo Y, Makino H, Miyamoto Y, Yoshimasa Y. Association of plasma B-type natriuretic peptide levels with obesity in a general urban Japanese population: The Suita Study. <i>Endocr J<\/i> 2010; 57: 727\u2013733, doi:10.1507\/endocrj.k10e-067.","DOI":"10.1507\/endocrj.K10E-067"},{"key":"37","doi-asserted-by":"crossref","unstructured":"37. Sarvazyan AP. Low-frequency acoustic characteristics of biological tissues. <i>Polymer Mechanics<\/i> 1975; 11: 594\u2013597, doi:10.1007\/BF00856791.","DOI":"10.1007\/BF00856791"},{"key":"38","doi-asserted-by":"publisher","unstructured":"38. Mast TD. Empirical relationships between acoustic parameters in human soft tissues. <i>Acoustics Res Lett Online<\/i> 2000; 1: 37\u201342, doi:10.1121\/1.1336896.","DOI":"10.1121\/1.1336896"}],"container-title":["Circulation Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/89\/10\/89_CJ-25-0098\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T03:37:52Z","timestamp":1758944272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/89\/10\/89_CJ-25-0098\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":38,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1253\/circj.cj-25-0098","relation":{},"ISSN":["1346-9843","1347-4820"],"issn-type":[{"value":"1346-9843","type":"print"},{"value":"1347-4820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]},"article-number":"CJ-25-0098"}}