Prediction for blood lactate during exercise using an artificial intelligence-Enabled electrocardiogram: a feasibility study.

Huang SC; Department of Physical Medicine and Rehabilitation, New Taipei Municipal Tucheng Hospital,  Taiwan.;
Lee CH; Hsu CC; Chang SY; Chen YA; Chiu CH; Hsiao CC; Su HR; S

Frontiers in physiology [Front Physiol] 2023 Oct 25; Vol. 14, pp. 1253598.
Date of Electronic Publication: 2023 Oct 25 (Print Publication: 2023).

Introduction: The acquisition of blood lactate concentration (BLC) during exercise is beneficial for endurance training, yet a convenient method to measure it remains unavailable. BLC and electrocardiogram (ECG) both exhibit variations with changes in exercise intensity and duration. In this study, we hypothesized that BLC during exercise can be predicted using ECG data.
Methods: Thirty-one healthy participants underwent four cardiopulmonary exercise tests, including one incremental test and three constant work rate (CWR) tests at low, moderate, and high intensity. Venous blood samples were obtained immediately after each CWR test to measure BLC. A mathematical model was constructed using 31 trios of CWR tests, which utilized a residual network combined with long short-term memory to analyze every beat of lead II ECG waveform as 2D images. An artificial neural network was used to analyze variables such as the RR interval, age, sex, and body mass index.
Results: The standard deviation of the fitting error was 0.12 mmol/L for low and moderate intensities, and 0.19 mmol/L for high intensity. Weighting analysis demonstrated that ECG data, including every beat of ECG waveform and RR interval, contribute predominantly.
Conclusion: By employing 2D convolution and artificial neural network-based methods, BLC during exercise can be accurately estimated non-invasively using ECG data, which has potential applications in exercise training.
Competing Interests: Author H-RS are employed by Super Genius Aitak Co., LTD. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.