A Masked Representation Learning to Model Cardiac Functions Using Multiple Physiological Signals

In clinical settings, monitoring hemodynamics is crucial for managing patient prognosis, necessitating the integrated analysis of multiple physiological signals. While recent research has analyzed single signals such as electrocardiography (ECG) or photoplethysmography (PPG), there has yet to be a proposal for an approach that encompasses the complex signal analysis required in actual clinical scenarios. In this study, we introduce the SNUPHY-M (Seoul National University hospital PHYsiological signal Masked representation learning) model extracts physiological features reflecting the electrical, pressure, and fluid characteristics of the cardiac cycle in the process of restoring three masked physiological signals based on self-supervised learning (SSL): ECG, PPG, and arterial blood pressure (ABP) signals. By employing multiple physical characteristics, the model can extract more enriched features only using non-invasive signals. We evaluated the model's performance in clinical downstream tasks such as hypotension, stroke volume, systolic blood pressure, diastolic blood pressure, and age prediction. Our results showed that the SNUPHY-M significantly outperformed supervised or SSL models, especially in prediction tasks using non-invasive signals. To the best of our knowledge, SNUPHY-M is the first model to apply multi-modal SSL to cardiovascular analysis involving ECG, PPG, and ABP signals. This approach effectively supports clinical decision-making and enables precise diagnostics, contributing significantly to the early diagnosis and management of hemodynamics without invasiveness.